Table 2.
Contribution of bone marrow aspiration to diagnosis and treatment
| Patient | Indication | Diagnostic contribution, N = 37 | Therapeutic contribution, N = 14 |
|---|---|---|---|
| 1 | b | Hemophagocytic syndrome | No |
| 2 (a) | b | Maturation arrest of granulocyte precursors | No |
| 3 (a) | c | Acute transformation of CMML | DFLST |
| 4 | d | Maturation arrest of granulocyte precursors | No |
| 5 (a) | c | Maturation arrest of granulocyte precursors | No |
| 6 | c | No (normal marrow) | Addition of erythropoietin |
| 7 | c | Marginal zone lymphoma | No |
| 8 (a) | c | No (normal marrow) | Addition of dasatinib |
| 9 (a) | e | Maturation arrest of granulocyte precursors | Discontinuation of TMP/SMX |
| 10 | e | Hemophagocytic syndrome | No |
| 11 | c | Lymphocytic lymphoma | No |
| 12 | e | No (presence of phagocytic histiocytes) | Addition of etoposide |
| 13 | e | Myelodysplastic syndrome | No |
| 14 | b | Hemophagocytic syndrome | No |
| 15 | c | Diffuse large B cell lymphoma | Addition of COP (g) |
| 16 | c | Marginal zone lymphoma | No |
| 17 | d | Maturation arrest of granulocyte precursors | No |
| 18 (a) | c | Acute monocytic leukemia | DFLST |
| 19 | c | Acute myeloid leukemia | DFLST |
| 20 | e | Hemophagocytic syndrome | No |
| 21 | e | Hemophagocytic syndrome | No |
| 22 | c | Myelodysplastic syndrome | No |
| 23 (a) | c | Relapsed multiple myeloma | No |
| 24 | e | Hemophagocytic syndrome | No |
| 25 | d | Maturation arrest of granulocyte precursors | Discontinuation of tacrolimus |
| 26 | e | Hemophagocytic syndrome | No |
| 27 (a) | c | Hemophagocytic syndrome | No |
| 28 | c | Multiple myeloma | No |
| 29 | e | Myelodysplastic syndrome | No |
| 30 | e | Myelodysplastic syndrome | No |
| 31 | b | Hemophagocytic syndrome | No |
| 32 | f | Diffuse large B cell lymphoma | Addition of COP (g) |
| 33 (a) | c | Myelodysplastic syndrome | No |
| 34 | e | Hemophagocytic syndrome | Addition of etoposide |
| 35 (a) | c | Hemophagocytic syndrome | No |
| 36 | e | Hemophagocytic syndrome | No |
| 37 | d | Maturation arrest of granulocyte precursors | Addition of lenogastrim |
| 38 | d | Maturation arrest of granulocyte precursors | Discontinuation of amoxicillin |
| 39 | d | Maturation arrest of granulocyte precursors | Addition of lenogastrim |
| 40 (a) | c | Maturation arrest of granulocyte precursors | No |
In patients 6, 8, and 12, BMA did not contribute to diagnosis but contributed to treatment
a, hematological malignancy or cancer already known upon ICU admission; b, suspicion of hemophagocytic lymphohistiocytosis; c, suspicion of hematological malignancy; d, agranulocytosis; e, thrombocytopenia; f, suspected cancer that has spread to the bone marrow; g, ultimately followed by DFLST; CMML, chronic myelomonocytic leukemia; COP, cyclophosphamide, vincristine, prednisone; DFLST, decision to forego life-sustaining treatment; TMP/SMX, trimethoprim/sulfamethoxazole