Onkologie. 2012:6(3):138-142

Bone marrow biopsy in myeloproliferative neoplasms - the need or the anachronism?

Juraj Marcinek^1,3, Tatiana Burjanivová², Lukáš Plank^1,3

¹ Ústav patologickej anatómie JLF UK a UNM, Konzultačné centrum bioptickej diagnostiky ochorení krvotvorby v SR

² Ústav molekulovej biológie JLF UK, Martin, Slovenská republika

³ Martinské bioptické centrum, s. r.o. Martin, Slovenská republika

WHO classification (2008) is the only world-wide accepted and in routine praxis used classification of bone marrow (BM) neoplasms defining

also the importance of BM biopsy within the diagnostic algorithm. Myeloproliferative neoplasias (MPN) represent a heterogenous

group of disorders with variable dynamic transformational potential from initial into advanced stages such as blast crisis or myelofibrotic

transformation. Because of similar manifestations, the typing of MPN in their initial stages based on clinical and laboratory parameters

is not optimal. The finding of MPN-typical genetic mutations proves the disease clonality, but not a diagnosis of individual MPN types.

In contrast, the BM biopsy verifies both the diagnosis and MPN type. It helps also to discriminate MPN from reactive hematopoietic

changes, to evaluate prognostically relevant BM features (e.g. grade of myelofibrosis, blasts number) and the follow-up to terminal

stages. However, the MPN typing in terminal and posttherapeutical stages based on morphology alone is not sufficient. The diagnostic

value of BM biopsy depends on specimen´s quality, the objectivity of BM morphology evaluation depends on pathologist´s training and

experiences. A correct BM biopsy interpretation should be done within the context of sufficient clinical and laboratory data and with

support of genetical analyses.

myelofibrosis, bone marrow biopsy.

Keywords: myeloproliferative neoplasms, Ph1 negative myeloproliferation, polycythemia vera, esential trombocythemia, primary

Published: July 31, 2012  Show citation