The spectrum of pathologies found in bone marrow amongst children below 18 years at Kenyatta national hospital, Kenya
Hematology & Transfusion International Journal
Bone marrow examination is a key investigation for both haematological and non-haematological disorders where the bone marrow is involved. Bone marrow examination consists of bone marrow aspiration and bone marrow trephine biopsy which complement each other. Objectives: To describe the spectrum of pathologies found in the bone marrow of children below 18 years old at Kenyatta National Hospital and to determine the clinical features at presentation observed with the different pathologies found.
... pathologies found. Study design and site: This was a descriptive cross-sectional study carried out from Method: The registry at the Department of Human Pathology, University of Nairobi, was used to identify the eligible children who had a bone marrow aspirate/bone marrow trephine biopsy during the study period. The children were then traced back to their respective wards. The children were also recruited from the haematology clinic. Consent to use clinical data from their files and their bone marrow aspirate/bone marrow trephine biopsy reports were sought from parents/guardians and assent were obtained from minors aged 8 years and above. The information was collected using a structured questionnaire. The information was then analysed using SPSS software version 23.0. Results: A total of 90 patients' files and bone marrow examination reports were analysed. Ages of the patients ranged from 6 months to 18 years. The mean age of the children who participated in the study was 6.70±4.82 years. The peak age group for a bone marrow examination was 1 year to 5 years (43.3%). Males were 52 (57.8%) and females were 38 (42.2%). The main findings were neoplastic disorders (52.4%) followed by reactive marrow (28%) and nutritional anaemia (8.6%). Among the neoplastic disorders, acute lymphoblastic leukaemia (34%) was the most common. The commonest clinical presentations observed were pallor (51.2%), fever (32.5%), fatigue (27.5%) and bleeding manifestations (20%). Conclusion: The main bone marrow pathology found was neoplastic disorder, the majority of which were acute lymphoblastic leukaemia. The most common clinical manifestations found were pallor, fever, fatigue and bleeding manifestations.