Diagnostic adequacy of adult bone marrow biopsies in Malawi: A retrospective cohort study

African Journal of Laboratory Medicine

 
 
Field Value
 
Title Diagnostic adequacy of adult bone marrow biopsies in Malawi: A retrospective cohort study
 
Creator Kasonkanji, Edwards Chikaonda, Tarsizious Eastburg, Luke Mulenga, Maurice Tomoka, Tamiwe Fedoriw, Yuri Painschab, Matthew Brownlee, Amy
 
Subject — bone marrow biopsy; diagnostic adequacy; haematologic disorders; lymphoproliferative disorders; pathology; Malawi
Description Background: Bone marrow (BM) sampling is a critical component of clinical care, informing the diagnosis of benign and malignant haematologic disorders.Objective: We aimed to assess adequacy and characterise the spectrum of diagnoses rendered for BM samples reviewed at Kamuzu Central Hospital in Lilongwe, Malawi.Methods: We reviewed clinical and pathologic data from all adult BM specimens seen at Kamuzu Central Hospital from 01 June 2012, through 30 June 2024, and utilised R to summarise clinical and diagnostic data.Results: We identified 602 BM samples, most of which were biopsy-only specimens (n = 335, 56%). Most patients were male (n = 345, 57%), with a median age of 42 years. Of the 539 (90%) patients with known HIV status, 372 (69%) were HIV-uninfected. The most frequent indications for BM sampling were anaemia (n = 188, 31%) and cancer staging (n = 118, 20%). There was no documented indication for 72 cases (12%). Excluding BM samples obtained for cancer staging (n = 118, 20%), there were 403 (83%) diagnostic samples. Of these, 156 (39%) were malignant, with 50 (32%) acute leukaemias and 38 (24%) lymphomas.Conclusion: We found a high diagnostic yield (85%) of BM samples in this cohort, along with a considerable proportion of new cancer diagnoses (39%) in diagnostic samples taken for reasons other than cancer staging. Non-malignant diagnoses were predominant, yet resources for subcategorising these are limited in our setting.What this study adds: This study highlights the high diagnostic yield of adult BM samples at Kamuzu Central Hospital and characterises these diagnoses, revealing not only a substantial burden of malignancies but also important gaps in diagnostic capacity.
 
Publisher AOSIS
 
Contributor
Date 2025-11-30
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/ajlm.v14i1.2966
 
Source African Journal of Laboratory Medicine; Vol 14, No 1 (2025); 7 pages 2225-2010 2225-2002
 
Language eng
 
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https://ajlmonline.org/index.php/ajlm/article/view/2966/3341 https://ajlmonline.org/index.php/ajlm/article/view/2966/3342 https://ajlmonline.org/index.php/ajlm/article/view/2966/3343 https://ajlmonline.org/index.php/ajlm/article/view/2966/3344
 
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Rights Copyright (c) 2025 Edwards Kasonkanji, Tarsizious Chikaonda, Luke Eastburg, Maurice Mulenga, Tamiwe Tomoka, Yuri Fedoriw, Matthew Painschab, Amy Brownlee https://creativecommons.org/licenses/by/4.0
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