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.
Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA 52242-1009, USA.
Elizabeth M
EM
Manion
Nancy S
NS
Rosenthal
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