Enhancing Diagnostic Precision in Malignant Hematological Disorders Through Risk Factor Analysis for High-Quality Bone Marrow Aspirate

Authors

• Olga G. Cantu-Rodriguez, Universidad Autonoma de Nuevo Leon
• Edgar G. Dorsey-Trevino, The University of Texas Rio Grande ValleyFollow
• Alan Contreras-Arce
• Jose A. Hawing-Zarate, Universidad Autonoma de Nuevo Leon
• Sara P. Gonzalez-Cantu
• Sofia L. Gonzalez-Cantu

Document Type

Article

Publication Date

3-26-2026

Abstract

Background: Previous evidence suggests that the diagnostic role of bone marrow aspiration (BMA) is altered by the hematological malignancy itself, thereby reducing its diagnostic accuracy and potentially delaying patient care. This association, however, remains largely unevaluated.

Methods: We used a multivariable logistic regression model to estimate the association between hematological malignancies and the quality of the BMA, defined as optimal or suboptimal. Our primary outcome evaluated the association between hematological condition type and the quality of the bone marrow aspirate. Our secondary outcomes were to determine laboratory and patient-specific risk factors associated with the quality of the bone marrow aspirate.

Results: We analyzed a total of 875 patients who had either acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), multiple myeloma (MM), or non-Hodgkin lymphoma (NHL). We found that patients with AML and MDS were associated with a suboptimal BMA (OR 0.72; 95% CI 0.56-0.91 and OR 0.63; 95% CI 0.50-0.79, respectively). We also found that in patients with AML and MDS, age was associated with a suboptimal BMA (OR 0.63; 95% CI 0.49-0.81 and OR 0.72; 95% CI 0.53-0.97), whereas high levels of hemoglobin (OR 2.56; 95% CI 2.07-2.98 and OR 1.16; 95% CI 1.02-1.35), and platelets (OR 1.27; 95% CI 1.07-1.44 and OR 1.34; 95% CI 1.11-1.49) were associated with an optimal BMA.

Conclusions: We found that in AML and MDS, factors such as advanced age, low levels of hemoglobin, platelets, and white blood cells are associated with the quality of the BMA, thereby impacting its diagnostic accuracy.

Comments

© 2026 John Wiley & Sons Ltd.

Recommended Citation

Cantu-Rodriguez, O. G., Dorsey-Trevino, E. G., Contreras-Arce, A., Hawing-Zarate, J. A., Gonzalez-Cantu, S. P., Gonzalez-Cantu, S. L., Gutierrez-Aguirre, C. H., Colunga-Pedraza, P., Gomez-De Leon, A., & Gomez-Almaguer, D. (2026). Enhancing Diagnostic Precision in Malignant Hematological Disorders Through Risk Factor Analysis for High-Quality Bone Marrow Aspirate. International journal of laboratory hematology, 10.1111/ijlh.70100. Advance online publication. https://doi.org/10.1111/ijlh.70100    

Publication Title

International journal of laboratory hematology

DOI

10.1111/ijlh.70100

Academic Level

resident

Mentor/PI Department

Internal Medicine