Bone Marrow Analysis

Bone Marrow Biopsy and Histology

Blast percentages in peripheral blood and bone marrow are determined by microscopic visualization.1

Bone marrow analyses (including immunophenotyping by immunohistochemistry stains with flow cytometry) and cytogenetic analyses (karyotype with fluorescence in situ hybridization [FISH]) are necessary for stratifying risk and to potentially guide therapy of AML.2

The bone marrow biopsy provides insight into the3:

  • Degree of disease involvement
  • Specific histologic features associated with the leukemic process (eg, necrosis, fibrosis)

The bone marrow aspirate provides material to determine3:

  • Blast cell count and ratio of myeloid to erythroid precursors (M:E)
  • Cytologic evaluation of the blasts and other cells that may be residual normal hematopoietic elements or abnormal cells maturing from the blasts

References: 1. Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114(5):937-951. 2. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.3.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed March 3, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 3. Orazi A. Histopathology in the diagnosis and classification of acute myeloid leukemia, myelodysplastic syndromes, and myelodysplastic/myeloproliferative diseases. Pathobiology. 2007;74(2):97-114.