Review Article

Practical Guide to Bone Marrow Sampling for Suspected Myelodysplastic Syndromes

Jean A. Ridgeway,(1) DNP, APN, NP-C, AOCN®, Sara Tinsley,(2) PhD, ARNP, AOCN®, and Sandra E. Kurtin,(3) RN, MS, AOCN®, ANP-C

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

1) University of Chicago Medical Center, Chicago, Illinois; 2) H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida; 3) University of Arizona Cancer Center, Tucson, Arizona Jean A. Ridgeway, DNP, APN, NP-C, AOCN®, Department of Medicine, Section of Hematology/Oncology, The University of Chicago Medicine, 5841 S. Maryland Ave., MC 2115, Chicago, IL 60637. E-mail: jridgewa@medicine.bsd.uchicago.edu

ABSTRACT

Myelodysplastic syndromes (MDS) comprise a group of diverse clonal hematopoietic stem cell malignancies that are characterized by ineffective hematopoiesis and progressive bone marrow failure. Clinical symptoms are generally nonspecific. The diagnosis, classification, and risk stratification of MDS rely on the evaluation of peripheral blood and bone marrow sampling using the Revised International Prognostic Scoring System tool. Accurate diagnosis and risk stratification require a good-quality bone marrow sample. Bone marrow samples are obtained using two complementary techniques: bone marrow aspiration and bone marrow biopsy. Knowledge of what constitutes an adequate bone marrow sample and a proper bone marrow sampling technique may help advanced practitioners obtain quality samples while minimizing patient discomfort and risk. Patient preparation and positioning, site selection, sampling equipment, and sampling technique can help lead to the collection of high-quality bone marrow samples. Postprocedural care and knowledge of potential complications can reduce a patient’s pain and optimize recovery

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