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Bone marrow biopsy depends on tissue morphology, immunohistochemical staining, and moleculardetection. Tissue pretreatment is required for bone marrow samples, from clinical specimen acquisition to pathological reporting, but during the process, proteins and nucleic acids are often altered because of the acid in fixation and decalcification solutions. In our study, we present an easy and effective pretreatment protocol and compared this novel pretreatment protocol (Set 2) with an existing traditional pretreatment process (Set 1) using tissue morphology, IHC staining, and molecular pathological analyses. Granulocytic IHC markers showed more intensive staining in samples of Set 2 than in those of Set 1. The Set 2 protocol provided a higher DNA yield and less fragmentation; moreover, samples processed with the Set 2 protocol could be subsequently used in FISH and DNA sequencing assays. Our optimized novel pretreatment protocol could better protect proteins and DNA molecules while maintaining good cell morphology compared to traditional pretreatment The novel pretreatment reagents could role as a reference by more laboratories for pretreating bone marrow biopsy samples and scientific research., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier GmbH.)

Most guidelines suggest that only the bone marrow aspirate (BMA) is necessary to assess residual disease following intensive chemotherapy for Acute Myeloid Leukemia (AML) with the bone marrow trephine biopsy (BMTB) recommended in cases of a poor quality BMA. We performed a retrospective study evaluating this in a cohort of patients receiving intensive chemotherapy for AML. Residual disease was assessed by morphological examination of the BMA and BMTB ± immunohistochemistry. Of the 647 marrows 32.6% were interim marrows performed prior to peripheral count recovery, 41.7% were end of induction (EOI) marrows and the remaining were ‘other marrows’. The BMA and BMTB findings were concordant in 92.8% of cases. The BMTB led to a change in diagnosis from ‘no leukemia’ to ‘residual leukemia’ in 5.2% of interim, 3.7% of EOI and 2.4% of ‘other’ marrows. The BMA alone had a sensitivity of 86.8% in detecting residual leukemia and of 82.3%, 82.5% and 94.2% for interim, EOI and ‘other marrows’, respectively. Despite the high concordance between the BMA and the BMTB the poor sensitivity of the BMA in detecting residual leukemia, particularly at EOI, may lead to an overestimation of the complete remission rates which may have therapeutic and clinical trial implications. [ABSTRACT FROM AUTHOR]

This study aimed to document the morphological and immunophenotypic features, and describe the diagnostic features of bone marrow ( BM) involvement in human herpes virus 8 Multicentric Castleman disease ( HHV8- MCD). BM trephine biopsy ( BMTB) specimens from 28 patients were revisited. Samples were evaluated for expression of CD3, CD20, CD138, CD68R, glycophorin C, CD42b, HHV8-latency-associated nuclear antigen ( LANA1), Epstein-Barr virus-encoded small RNA and light chains. Presence of significant numbers of HHV8- LANA1+ lymphoid/plasmacytic cells, noted in 10/28 cases, was indicative of BM involvement and was associated with low CD4 and CD8 counts in peripheral blood. The characteristic morphological appearance of MCD seen in lymph nodes is a rare finding in BMTB. 4/5 cases with lymphoid aggregates were involved by MCD, whereas 6/23 cases without lymphoid aggregates were involved by MCD ( P = 0·023). 9/18 cases with hypercellular marrow were involved by MCD, whilst only 1/8 cases with normo/hypocellular marrow showed involvement by MCD ( P = 0·070). While 9/21 cases with increased marrow reticulin were involved by MCD, none of the cases with no increase in reticulin were involved by MCD ( P = 0·080). Reactive plasmacytosis is a frequent finding. We conclude that bone marrow is involved in a significant proportion of patients with MCD (36%), and involvement can be identified by HHV8- LANA1 immunohistochemistry. [ABSTRACT FROM AUTHOR]

Abstract: Evaluation of remission in adult acute lymphoblastic leukemia (ALL) normally relies on cytologic evaluation and flow-cytometric analysis. The diagnostic impact of bone marrow trephine biopsies has not been studied so far. We investigated 26 biopsies of 16 patients with T-ALL. Double fluorescent immunostaining with TdT and CD3 was performed. Corresponding cytologic evaluation and flow-cytometric data were available. In 17 of 26 investigations, the results were concordant (either positive or negative). In one examination, residual blasts were not recognized by trephine biopsy, but by other methods. By contrast, in eight investigations, the leukemic blasts were found only in the bone marrow trephine biopsies. Regarding the evaluation of remission of T-ALL, in our retrospective study, bone marrow trephine biopsies with double immunostaining were found to be sensitive and specific for the detection of residual blasts. This method may add to the conventional cytology and flow-cytometric analysis. [Copyright &y& Elsevier]

Bone marrow (BM) examination is a routine staging procedure in follicular lymphoma (FL). Commonly, both BM histology as well as flow cytometry (FCM) of BM aspirates are performed. In order to compare the diagnostic value of these two techniques, we retrospectively evaluated trephine BM biopsies and listmode data of patients with a confirmed diagnosis of FL, obtained in parallel during a 5-year period. One hundred and thirty nine specimens from 91 patients with FL were eligible for analysis. After joint review, nine cases (6.5%) were reclassified, either in histology (six cases) or FCM (three cases). Seventy nine specimens (57%) showed no infiltration with both methods. Sixty specimens (43%) were scored positive for BM involvement by any of the two techniques. Concordant positive results were obtained in 41 cases (68% of positive BM). False negative results were obtained by FCM in 14 cases (23% of positive BM) and by histology in five cases (8%). Discrepant results between BM histology and FCM are frequent in patients with FL, most likely due to the predominantly paratrabecular infiltration and fibrosis typical for FL. Due to the lower false negative rate, trephine BM biopsy remains crucial for the detection of BM involvement in FL. [ABSTRACT FROM AUTHOR]

Akkaya H, Dogan O, Agan M, Dincol G. The value of tatrate resistant acid phosphatase (TRAP) immunoreactivity in diagnosis of hairy cell leukemia. APMIS 2005;113:162–6.Hairy cell leukemia (HCL) is a rare chronic B-cell lymphoproliferative disorder characterized by splenomegaly, pancytopenia, and circulating atypical lymphocytes with circumferential cytoplasmic projections. We investigated the specificity and the sensitivity of anti-TRAP antibody immunoreactivity in 57 cases of HCL. We found that there is a statistically highly significant difference between TRAP immunoreactivities of the study and the control groups, and HCL can be diagnosed by TRAP immunoreactivity in bone marrow trephine biopsy materials with a specificity of 98.27 % and a sensitivity of 100%. [ABSTRACT FROM AUTHOR]