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Bone marrow double stain (CD3 and CD79a), courtesy of Jim Burchette, Duke Immunopathology.

Bone Marrow Examination: Clinical Indications

Often, peripheral blood smears are used in conjunction with laboratory and clinical data to evaluate blood abnormalities, such as anemia. When a definitive diagnosis cannot be determined from a peripheral blood smear sample, clinicians may make the decision to perform a bone marrow examination (BME).
Although clinical indications for unilateral bone marrow examination can be determined on a case-by-case basis, there are some common clinical indications used to triage the medical necessity of the procedure. The unilateral BME is most often used to evaluate pervasive (wide spread) disease, such as:
  • Anemia
  • Leukemia (acute and chronic)
  • Storage disease
  • Myelodysplastic disorders, myeloproliferative neoplasms
  • Fevers of unknown origin (infectious disease)
  • Thrombocytopenia
  • Pancytopenia
  • Neutropenia
  • Immunodeficiency
Additionally, there are some common clinical indications used to triage the medical necessity of a bilateral BME. The bilateral BME is most often used to evaluate more patchy disease processes, such as:
  • Hodgkin's lymphoma
  • Non-Hodgkin's lymphoma
  • Plasma cell myelomas
  • Metastatic tumors