Bone marrow biopsies in patients 85 years or older.
Increasing numbers of bone marrow aspirates and core biopsies are done in very elderly people; there is little published literature regarding the usefulness of bone marrow biopsies in these patients. We undertook a retrospective review of 119 bone marrow aspirates and biopsies from patients 85 years or older. These procedures were performed for a variety of abnormalities, including unexplained cytopenias; evaluation of a known myelodysplastic syndrome; suspicion or follow-up of plasma cell myeloma, thrombocytosis, or leukocytosis; and suspicion or staging of lymphoma. When staging or follow-up biopsies were excluded, 34 (43%) of 79 yielded specific diagnoses. Follow-up was available for 45 patients, and of these 45, 20 patients received therapy: 17 were treated with an abbreviated or modified regimen, and 12 were treated for leukemia/lymphoma. Therapy failed in all patients. As a result of these biopsies, relatively few patients received more than supportive treatment, suggesting that higher thresholds for biopsy for cytopenias may be indicated.
Manion
Elizabeth M
EM
Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA 52242-1009, USA.
Rosenthal
Nancy S
NS
D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis; D001706:Biopsy / Q000706:statistics & numerical data*; D001853:Bone Marrow / Q000473:pathology; D001856:Bone Marrow Examination / Q000706:statistics & numerical data*; D006402:Hematologic Diseases / Q000175:diagnosis; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis; D008232:Lymphoproliferative Disorders / Q000175:diagnosis; D009190:Myelodysplastic Syndromes / Q000175:diagnosis; D012189:Retrospective Studies