Morphological Spectrum of Bone Marrow Findings and its role in the Evaluation of Haematological Disorders

Introduction: Bone marrow examination (BME) is a cornerstone diagnostic procedure for evaluating hematological disorders, providing critical insights into cellular morphology, architecture, and iron stores. This study aimed to describe the clinico-morphological spectrum of bone marrow findings and assess the diagnostic utility of bone marrow aspiration (BMA) and biopsy (BMB) in a tertiary care center in the Bundelkhand region of Madhya Pradesh, India. Materials and Methods: A prospective, observational study was conducted over a specified period, including 90 patients who underwent BME for various hematological indications. Peripheral blood parameters, clinical features, and bone marrow morphology from both aspiration and trephine biopsy were analyzed. Special stains (Perls’ Prussian blue, Reticulin) were employed as needed. Results: The study population had a mean age skewing towards younger adults (20-29 years, 31.1%), with a slight male predominance (53.3%). The most common clinical features were weakness (90%) and pallor (88.9%). Megaloblastic anemia (MA) was the most frequent diagnosis (31.1%), followed by mixed deficiency anemia (MDA, 20.0%) and iron deficiency anemia (IDA, 11.1%). Non-neoplastic disorders constituted 85.5% of cases, while neoplastic conditions like acute leukemia, aplastic anemia, and myelofibrosis accounted for 14.4%. Bone marrow biopsy was pivotal in cases of dry tap or when architectural assessment was crucial, such as in myelofibrosis and aplastic anemia. Conclusion: Nutritional deficiency anemias, particularly megaloblastic anemia, are the predominant hematological disorders in the Bundelkhand region. Bone marrow examination remains an indispensable, costeffective tool for definitive diagnosis, especially in differentiating between nutritional deficiencies, marrow failure syndromes, and hematological malignancies.