Modified Giemsa Stain: A solution to improve the quality of hypercellular bone marrow smears.

INTRODUCTION

Morphology is still the cornerstone of the diagnosis of haematological malignancies where the quality of staining plays a major role. The hypercellularity of a smear interferes with the quality of staining. We compared a newly modified giemsa stain (MGS) as a routine method for staining hypercellular bone marrow smears over the conventional Leishman method and the May Grunwald Giemsa method (MGG) in a completely randomized block study.

METHODS

Quality of staining, cost, labour intensiveness and turnaround time of the new method was compared with MGG and Leishman methods for bone marrow smears of acute leukaemia using 30 cases. Bone marrow smears were blindly reviewed for the degree of staining of nuclei, cytoplasm and granules on a scale of 0 to 4 and statistically analysed by Minitab 16.

RESULTS

A significant difference (p < .05) was revealed for the quality of staining of nuclei, cytoplasm and granules, and it was found that the new MGS was superior to the MGG and Leishman method. The cost of staining was lowest in the new MGS and the staining time of the new MGS was 76% less than MGG and 9.09% greater than the Leishman method. In terms of turnaround time, the new MGS is somewhat similar to the Leishman method and is user-friendly with a lesser number of steps to follow, compared with MGG.

CONCLUSION

Our study showed that the new MGS is overall far superior, cost-effective and user-friendly compared with other conventional staining methods when used for hypercellular bone marrows.