ICH-ISHBT Recommendations On Bone Marrow Aspiration/Imprint Smear Synoptic Reporting

Bone marrow sampling [including bone marrow aspirate (BMA), trephine biopsy touch imprint (BMI), and the bone marrow trephine biopsy (BMBx)] is a very important test in the diagnosis and/or follow-up monitoring of both hematological and many non-hematological conditions. A synoptic report for BMA/BMI cytology aims to bring homogeneity in reporting among pathologists/laboratory hematologists/hematopathologists across academic and practicing centres, and ensure completeness in communicating with clinicians with actionable suggestions. The essence of such reporting format is to bring out the accuracy in reporting that will incorporate treating physician/hematologist's perspective, essential patient related clinical information gathered and documented during bone marrow sampling, careful interpretation of freshly prepared and stained peripheral blood smear (PBS) morphology, recent complete blood count parameters, and meticulous evaluation of hematopoietic and non-hematopoietic elements in the bone marrow. The integrated PBS-BMA-BMI report should be made available in a time bound manner maintaining reasonable turnaround time. It should be clear and comprehensive, and every attempt should be made to offer preliminary vital diagnostic information regarding the underlying disease process wherever possible; suggest requisite routine and/or specialized ancillary testing; and finally guide the treating physician for further plan of patient management. The BMA-BMI reporting should be followed-up with that of BMBx, preferably, by the same reporting personnel. This ICH-ISHBT taskforce consensus document on BMA and BMI synoptic reporting intends to address the above issues, bring out homogeneity, and improve the quality of patient care at par with national and international standards.