TY  - JOUR
TI  - Bone Marrow Examinations in 85 Years or Older Geriatric Patients: Indications, Morbidity and Diagnosis.
AB  - As a result of the population aging, the incidence of both hematologic and non-hematologic diseases of elderly gets higher, requiring bonemarrow (BM) aspirations and biopsies be implemented also in the geriatric patients. Our aim in this study is to address BM examinationin the geriatric patients aged 85 and over, describing its indications and morbidity and discussing the established diagnoses and outcomesof applied therapies based on BM examinations in comparison to the available literature which is actually limited in number particularly inthis patient group. We have retrospectively reviewed the BM aspiration/biopsy results of 114 patients aged ≥ 85 years who were followed-upby hematology department of a university hospital from 2010 to 2020. The patients were selected through the internal data handling systemof the hospital using the entry codes corresponding to BM aspiration and biopsy and those at the age of 85 or older were identified. Demographic features, primary diagnosis, any comorbidities, complete blood count (CBC) details, erythrocyte sedimentation rate (ESR), red bloodcell indices, C-reactive protein (CRP), serum ferritin, vitamin B12, and folic acid levels, any abnormal results in serum biochemistry testing,the indication(s) for and the result(s) from BM aspiration/biopsy, and the treatments applied based on those result(s) were recorded foreach patient as well as the rates of and reasons for mortality. In our cohort of 114 patients with a mean age of 86.3±1.7 (85-93) years, 64.9%(n=74) were males. None of the patients experienced any serious complication during BM aspiration and biopsy. First three indications inour cohort for BM aspiration/biopsy in decreasing order of frequency were cytopenia in 48.2% (n=55), anemia + elevated ESR in 18.4%(n=21), and leukocytosis + anemia + thrombocytopenia in 15.8% (n=18). BM aspiration/biopsy results gave rise to a pathologic or hematologic diagnosis in 85.9% (n=98) and 78.9% (n=90) of patients, respectively. Most frequent hematologic malignancies were myelodysplasticsyndrome (MDS), acute myeloid leukemia (AML), and multiple myeloma (MM). Kaplan-Meier analysis revealed hemoglobin (Hb) andLDH levels as prognostic factors with an impact on mortality. Prognostic factors with an impact on mortality based on multivariate stepwiseCox regression analysis, on the other hand, were uric (p= 0.018, hazard ratio (HR)= 1.134, 95% confidence interval (CI) = 1.022-1.258),LDH (p=0.092, HR=1.001, 95% CI= 1.000-1.002), and platelet levels (p=0.007, HR=1.000, 95% CI=1.000-1.000). BM examination shoulddefinitely be performed in patients aged ≥ 85 years, particularly in the event of cytopenia, unexplained anemia, and elevated ESR both fordiagnostic purposes and to prolong life expectancy through administration of modified therapies depending on the performance status. Insuch patients uric acid, LDH and platelet levels should be closely followed-up as independent prognostic variables which effect mortality
AU  - BAL, CENGIZ
AU  - Andic, Neslıhan
AU  - DAVUTOGLU, Nur Oguz
AU  - Üsküdar Teke, Hava
AU  - GUNDUZ, Eren
DO  - 10.20515/otd.852348
PY  - 2021
JO  - Osmangazi Tıp Dergisi
VL  - 43
IS  - 3
SN  - 1305-4953
SP  - 273
EP  - 282
DB  - TRDizin
UR  - http://search/yayin/detay/411812
ER  -