RETROSPECTIVE ANALYSIS OF THE QUALITY OF BONE MARROW SMEARS RECEIVED BY AN ACADEMIC INSTITUTION

Introduction: Aspiration of bone marrow and direct examination of the smear are both important tools in the study of haematological and non-haematological diseases. Examination of the bone marrow smear allows assessment of cell morphology and enumeration of the cellular elements within the bone marrow allowing confirmation of a suspected clinical diagnosis. In the Specials Haematology Laboratory within the Department of Haematology at the University of Pretoria, it has been speculated that the number of sub-optimal bone marrow smears that are received for diagnostic analysis is high. Study purpose: The purpose of the study was to analyse the quality of bone marrow smears received. Methods: All the reports of the bone marrow smears received between April 2010 and March 2014 were analysed to determine if the smears were sub-optimal or not. A smear is defined as sub-optimal when no clear diagnosis of illness/disease can be made by the examining pathologist from the bone marrow smear due to various reasons. Results: It was found that 41.8% of smears that were received in the study time period were of a sub-optimal quality and could not be used for diagnostic purposes. The main reasons were that bone marrow aspirates were not performed correctly and that the marrow or slides were contaminated with various substances which made adequate examination of the bone marrow smear impossible. Conclusion: The data will assist the Department of Haematology in correcting the problem in the future ensuring more accurate and quicker diagnoses.