title: Estimation of bone marrow cellularity using digital image nucleated cell counts in patients receiving chemotherapy.
abstract: BACKGROUND
  Bone marrow cellularity under microscopic examination has a wide range of variation. The number of nucleated cells in a certain volume of bone marrow could represent more accurate cellularity. In this study, we compared the cellularity under the microscope with the nucleated cell counts on the biopsy sections to assess the usefulness of nucleated cell count as a representative cellularity marker.
  
  
  METHODS
  Three hundred and twenty-five bone marrow biopsies were analyzed. Two pathologists determined bone marrow cellularity using digital images with ×100 magnification from biopsy sections. Nucleated cell counts on the digital images with ×100 magnification were determined using automated cell counting software.
  
  
  RESULTS
  A wide range of variation was observed in the nucleated cell counts among the biopsies with the same cellularity. A good correlation was observed between the cellularity under the microscope (×100 magnification) and the nucleated cell counts (r = 0.816, P < 0.05). The nucleated cell counts, using the automated cell counting software, had no significant interobserver difference (F = 0.001, P = 0.972). The intraclass correlation coefficient (ICC) of the nucleated cell count between two observers was 0.952.
  
  
  CONCLUSIONS
  The nucleated cell counts in the bone marrow biopsy could represent the number of residual hematopoietic cells more accurately than the method of cellularity under the microscope. The nucleated cell counts in the bone marrow biopsy could be especially helpful to determine cellularity after initial chemotherapy.
authors.affiliation: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Kim
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Han
authors.forename: K
authors.initials: K
authors.lastname: Han
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001706:Biopsy; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology*; D001854:Bone Marrow Cells / Q000187:drug effects / Q000473:pathology*; D002452:Cell Count; D002467:Cell Nucleus / Q000187:drug effects / Q000648:ultrastructure*; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008853:Microscopy; D015588:Observer Variation
chemical_list: D000970:Antineoplastic Agents
keywords: Nucleated cell count; bone marrow cellularity; interobserver difference