Related Experiment Videos
Bone marrow examination in newly diagnosed Hodgkin's disease: current practice in the United Kingdom
M R Howard1, P R Taylor, H H Lucraft
1Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Insights
Haematologists perform bone marrow examinations more often than clinical oncologists for Hodgkin
Area of Science:
- Oncology
- Hematology
Background:
- Hodgkin's disease management in the UK involves clinical oncologists and haematologists.
- Current practices for bone marrow examination in newly diagnosed Hodgkin's disease require evaluation.
Purpose of the Study:
- To assess the current performance and variations in bone marrow examination for Hodgkin's disease across different specialist groups in the UK.
Main Methods:
- A national study was conducted using questionnaires sent to consultants.
- Data were collected from 60% of consultants, detailing their bone marrow examination practices.
Main Results:
- Bone marrow examination was significantly more frequent among haematologists (74%) than clinical oncologists (40%).
- Clinical oncologists seeing over ten patients annually were less likely to perform routine biopsies.
- Selective bone marrow examination criteria (cytopenia, advanced stage) were consistently applied by both groups.
Conclusions:
- Bone marrow biopsy is performed more often than recommended for Hodgkin's disease.
- Significant practice variations exist between clinical oncologists and haematologists, highlighting the impact of specialization on patient care.
Abstract:
In the UK Hodgkin's disease is usually treated by either clinical oncologists or haematologists. A national study of the performance of bone marrow examination in newly diagnosed Hodgkin's disease was undertaken to establish current practice. A total of 620 questionnaires were despatched, and replies were received from 60% of consultants (45% of clinical oncologists and 70% of haematologists). Bone marrow examination was performed in all new cases significantly more often by haematologists than by clinical oncologists (74% vs 40%, P < 0.001). Among haematologists, there was no correlation between the number of new patients seen annually and practice, however clinical oncologists were even less likely to perform routine bone marrow biopsies if they saw more than ten patients per year (P < 0.02). Where bone marrow examination was performed selectively, the most common criteria used were peripheral blood cytopenia and advanced-stage disease. These criteria were applied in the same way by both clinical oncologists and haematologists. Bone marrow biopsy, an invasive and often painful procedure, is currently performed more frequently in Hodgkin's disease than can be recommended on the basis of recent studies in the literature and associated guidelines. There is a significant difference in practice between clinical oncologists and haematologists, and this raises the wider issue of the influence of hospital specialisation on patient management.