Patients with myelofibrosis, polycythemia vera, essential thrombocythemia, myelodysplastic syndromes, malignant lymphoma, multiple myeloma, amyloidosis, granulomatous disease, metastatic tumors, and other diseases require bone marrow examination. Apart from diseases, there are also some situations that require bone marrow examination.
1. Failed multiple aspirations;
2. To correctly determine the degree of bone marrow hyperplasia and its etiology in patients with hypocellular anemia;
3. Suspected patients with myelofibrosis, polycythemia vera, essential thrombocythemia, myelodysplastic syndromes, malignant lymphoma, multiple myeloma, amyloidosis, granulomatous disease, metastatic tumors, and aplastic anemia;
4. Bone marrow biopsy is meaningful for the diagnosis of acute myelogenous leukemia and the judgment of whether chemotherapy has achieved true complete remission. If the smear has reached complete remission, but leukemic blasts can still be detected in the biopsy specimens obtained by one-step double sampling, consolidation chemotherapy should continue until such abnormally located leukemic blasts disappear in the biopsy;
5. During post-remission chemotherapy and long-term disease-free survival of acute myelogenous leukemia, regular bone marrow one-step double sampling should be performed. If the cell count on the smear does not meet the criteria for relapse, but abnormal blasts appear in the biopsy, it suggests early relapse, and induction therapy should be promptly performed;
6. Routine bone marrow biopsy should be performed during the chronic phase of chronic myelogenous leukemia to determine the histological subtype of the patient;
7. Accurate assessment of iron storage in the bone marrow, especially when iron deficiency or depletion is suspected, is superior with iron staining on bone marrow biopsy specimens compared to smears;
8. Bone marrow biopsy can also provide meaningful information for the diagnosis of bone diseases themselves and certain bone marrow disorders, such as cystic fibrous osteitis, fibrous dysplasia of bone, osteitis deformans (Paget's disease), osteomalacia, osteoporosis, and fungal infections of the bone marrow cavity.
