Evaluation of Bone Marrow Trephine Biopsy: 134 Cases Over 8 Years -A Single Centre Experience

Background: Trephine biopsy is a core biopsy of bone marrow using a special needle to evaluate the marrow architecture. Taking bone marrow biopsy alongside aspirate is still the most preferred practice for precise diagnosis and evaluation of various haematological and non- haematological disorders. Aims and objective: This study was carried out to evaluate the importance of this procedure in the diagnosis of various haematological and non-haematological disorders especially when bone marrow aspirates alone are non-diagnostic and to assess the prognostic significance of haematological malignancy. Materials and Methods: This was a retrospective study using the trephine biopsy and aspiration reports extracted from hospital records of Delta Medical College Hospital, Dhaka, over an 8years period from May 2009 to December 2016.The patient's profiles along with corresponding diagnoses and the necessary investigation reports were analysed. Result: Eighteen (26.47%) patients had bone marrow involvement for non-Hodgkin's lymphoma, three (4.41%) patients for Hodgkin's lymphoma, and acute lymphoblastic leukaemia was diagnosed in 18 (13.43%) patients, metastatic deposits in 6 (4.5%) patients, acute promyelocytic leukaemia in 3 (2.2%) cases, aplastic anaemia in 7 (5.2%) cases, chronic lymphocytic leukaemia in 1 (0.75%) case, multiple myeloma in 3 (2.2%) cases, myelofibrosis in 6 (4.5%) cases and chronic myeloid leukaemia and immune thrombocytopenic purpura were found in less than 1% cases. Total 37 patients (54.41 %) were reported as normocellular marrow with normal maturation among all the cases of lymphomas (N=68). One trephine biopsy was carried out to assess remission after induction chemotherapy in ALL. Conclusion: Trephine biopsy is an invaluable diagnostic tool in case of diagnostic dilemma and for follow up of patients undergoing chemotherapy and bone marrow transplantation. An expert haematopathological evaluation of the bone marrow trephine can impart light on actual diagnosis and have tremendous impact regarding patient management.