Ebrahim Hussen, Fisha Temesgen, Debash Habtu, Bisetegn Habtye
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
J Blood Med. 2022 Feb 15;13:51-60. doi: 10.2147/JBM.S346091. eCollection 2022.
Hematological disorders are heterogeneous conditions ranging from malignant to non-malignant disorders. Hematological malignancies comprise a collection of heterogeneous conditions originating from cells of the bone marrow and the lymphatic system. Therefore, this study aimed to determine the pattern of bone marrow confirmed malignant and non-malignant hematological disorders in patients with abnormal hematological parameters.
Institutional-based cross-sectional study was conducted in Dessie town from April 2020 to June 2021. A total of 228 study participants who had abnormal hematological parameters and referred for bone marrow examination were included consecutively. About 1.5 mL of bone marrow sample and 3 mL of venous blood sample were collected for bone marrow examination, complete blood count analysis and peripheral blood morphology examination. Wright stain, Sudan black B, and Prussian blue stains were used for staining the bone marrow and peripheral blood smears. The result was expressed in mean and standard deviation and presented in texts and tables. Ratio, frequency, and percentage were used to express the magnitude of malignant and non-malignant hematological disorders.
The overall prevalence of hematological malignancies among the study participants was 11.4% with 8.8% in male patients. The prevalence of hematological malignancies were 3.5% CML, 2.6% AML, 1.8% CLL and MM, 0.9% ALL and undifferentiated acute leukemia. On the other hand, 57.0% of the study participants had non-malignant hematological disorders. Regarding non-malignant hematological cases, 24.6% were erythroid hyperplasia, 10.5% aplastic anemia, 8.8% concomitant IDA and MBA, 7.0% MBA, 3.5% leukemoid reaction, 1.8% IDA, and 0.9% visceral leishmaniasis. In patients with HM, 66.7% of AML, 100% of CML and CLL, and 75% of MM patients had increased total WBC count, whereas 66.7% of AML, 62.5% of CML, 75% of CLL, and 50% of MM patients had decreased hemoglobin level. On the other hand, 66.7% of AML, and 50% of CML, ALL, and CLL patients had decreased platelet count.
In this study, 11.4% of the patients had hematological malignant cases, whereas 57% of the patients had non-malignant hematological cases. Therefore, in patients with hematological abnormalities and where conclusive diagnosis could not be made through clinical and other laboratory investigations, bone marrow examination should be done for definitive diagnosis, management and prognosis.
血液系统疾病是一类异质性疾病，涵盖从恶性到非恶性疾病。血液系统恶性肿瘤包括一系列源自骨髓和淋巴系统细胞的异质性疾病。因此，本研究旨在确定血液学参数异常患者中经骨髓确诊的恶性和非恶性血液系统疾病模式。
2020年4月至2021年6月在德西镇开展了一项基于机构的横断面研究。连续纳入228名血液学参数异常并转诊进行骨髓检查的研究参与者。采集约1.5 mL骨髓样本和3 mL静脉血样本用于骨髓检查、全血细胞计数分析和外周血形态学检查。采用瑞氏染色、苏丹黑B染色和普鲁士蓝染色对骨髓和外周血涂片进行染色。结果以均值和标准差表示，并在文本和表格中呈现。采用比例、频率和百分比来表示恶性和非恶性血液系统疾病的严重程度。
研究参与者中血液系统恶性肿瘤的总体患病率为11.4%，男性患者为8.8%。血液系统恶性肿瘤的患病率分别为慢性粒细胞白血病（CML）3.5%、急性髓系白血病（AML）2.6%、慢性淋巴细胞白血病（CLL）和多发性骨髓瘤（MM）各1.8%、急性淋巴细胞白血病（ALL）和未分化急性白血病0.9%。另一方面，57.0%的研究参与者患有非恶性血液系统疾病。在非恶性血液系统病例中，红系增生占24.6%、再生障碍性贫血占10.5%、缺铁性贫血（IDA）合并骨髓增生异常综合征（MBA）占8.8%、MBA占7.0%、类白血病反应占3.5%、IDA占1.8%、内脏利什曼病占0.9%。在血液系统恶性肿瘤患者中，66.7%的AML、100%的CML和CLL以及75%的MM患者白细胞总数增加，而66.7%的AML、62.5%的CML、75%的CLL和50%的MM患者血红蛋白水平降低。另一方面，66.7%的AML以及50%的CML、ALL和CLL患者血小板计数降低。
本研究中，11.4%的患者患有血液系统恶性疾病，而57%的患者患有非恶性血液系统疾病。因此，对于血液学异常且无法通过临床和其他实验室检查做出明确诊断的患者，应进行骨髓检查以明确诊断、制定治疗方案和判断预后。
