Publication Date:
2011-11-18
Description:
Abstract 3133 The human bone marrow is often evaluated in patients with various hematological disorders. Multiple bone marrow procedures are often required in patients with hematological malignancies to guide their treatment. The instrument customarily employed, the Jamshidi needle, which involves manual rotary insertion into the marrow cavity of the posterior aspect of the iliac bone produces both an aspirate and a biopsy. Bone marrow biopsy procedure has changed very little in the last 40 years and is regarded by patients and physicians alike as a painful and uncomfortable procedure. In addition, suboptimal specimens including dilute aspirates and small core biopsies are often obtained, limiting the diagnostic potential of the procedure. Initial clinical studies utilizing a new powered bone marrow (PBM) device (OnControl, Vidacare Corporation, Shavano Park, TX), indicated that it was faster and easier to use for bone marrow aspirations than the traditional method. While the duration of the procedure has been consistently shorter, and the core samples larger for patients undergoing PBM in these reports, no studies have been carried out in teaching hospitals to determine whether or not the PBM system will be more readily mastered by hematologists-in-training. We conducted a prospective, randomized study to compare PBM with standard bone marrow procedure (SBM) in adults. PBM utilizes a battery-powered drill to insert the marrow needle into the iliac bone of adult hematology patients. This study was performed in 2 teaching hospitals employing hematologists-in-training. The primary endpoint of the study, the mean length of the marrow biopsy specimens, a surrogate for marrow quality, was determined by a pathologist in a blinded manner. Linear mixed effects models were fit to the data to compare the two techniques and adjust for the correlation in outcomes of procedures performed by the same fellow. 54 bone marrows (26 SBM and 28 PBM) were performed by 11 fellows under the observation and supervision of 3 attending hematologists and 1 research technologist. The primary endpoint was met. The mean length of the marrow biopsy specimens was found to be significantly longer (56%) for the PBM group (15.3 mm) than for the SBM group (9.8 mm), p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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