Culture failure in bone marrow aspirate samples is considered a quality indicator in routine P98

Cytogenetics; a benchmark of <5% is considered normal

Syeda Ambareen Zehra1, Azfar Ahmed2, Samuel Sharif3, Bushra Akhter4 and Mahesh Kumar5
Email: ambareen.zehra@tih.org.pk

Department of Pathology, Indus Hospital and Health Network Karachi, Pakistan

Background: Method: Chart Title Discussion:

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Karyotyping is an important element in The study was conducted at the 5 5 5 5 5 5 5 5 5 5 55 5 55 5 Failure of Cytogenetics studies is
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cancer cytogenetics. Many cytogenetic Cytogenetics department of IHHN from disappointing as it is important in
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abnormalities, which provide prognostic October 2020 to October 2021. A total of 3 diagnosis and for the targeted therapy
3 2
information. Conventional Cytogenetics still 406 samples were analyzed, depending 2
2 2 treatment of the patient. According to the
remains a requisite test, as it can detect on the cell count (1 - 2 million cells per 1
1 guidelines of Cytogenetic Abnormalities
numerical and structural abnormalities. culture). The samples were processed 0
0 0 0 0 0 0 0 2014, by Susan Mahler Zneimer, Ph.D,
Cytogenetic studies for hematological failure rate should not exceed 5% .

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with 24 hours (6-8 hrs ) from the time of
malignancies are complex. Multiple slides collection. When there was no other Overall incidence of culture failure in our
should be analyzed to get good possibility of getting a repeat sample, center is less than 5% which is
metaphases. The described rate of culture aged bone marrow aspirate samples (>24 % of repeat Bench Mark correlating with the Cytogenetic
failure in hematological malignancy is 5%. hrs) were processed as per the clinicians Abnormalities 2014, by Susan Mahler
Poor quality metaphases and banding,
Result: Zneimer, Ph.D.
request. Bone marrow aspirate samples
scanty metaphases, aged sample, technical were cultured without stimulation for 24 Out of 406 samples, 10 bone marrow
samples 2.4% (10/406) failed to produce
Conclusion:
error, ph change in the media, insufficient hours in 10 ml of RPMI media
sample, clotted sample, low and high cell supplemented with 10 percent Fetal any metaphases or produced a very Our study results indicated that sample
count constitute failure of culture. Bovine Serum, harvested, banded, and limited number of metaphases, viability decreases in specimens
analyzed. subsequently a full Karyotype was not processed beyond 24hrs of the time of
Objective: possible to produce. Out of these 10 collection, yielding higher numbers of
The culture failure is a tool which can be samples, 50%(5/10) were cultured after 24 culture failure. Successful karyotyping
Culture failure data 2020-2021
utilized as a one of the quality indicator in hrs due to delayed transportation, can be achieved by processing bone
Months % of Repeat Bench Mark
cytogenetics laboratory to assess the October 0 5%
30%(3/10) samples were with normal marrow samples within 24 hours ( as
standard practices not only for the timely November 0 5% count yielded poor quality of metaphases soon as possible) from the time of
culture processing but also for transportation December 1% 5% due to an inherent sample issue and /or collection. Due to the valuable nature of
conditions, technical skills, sample volume January 0% 5% technical problem and 20%(2/10) samples the bone marrow sample and the
and adequate TLC. This study was February 3% 5% had low volume with low TLC ranging from logistical limitations, it is not possible to
conducted to observe the significance of March 0% 5% 1.0 -3.0 / uL . reject these samples. However, the
transit time and sample cellularity in culture April 0% 5% All cultures were processed according to culture failure increases as time passes.
failure considering the sample volume and May 0% 5% the standard operating procedure without Ideally the sample should be processed
TLC. June 2% 5% deviation. A high rate of culture failure was within 24hrs of the time of collection to
July 2% 5% observed in samples older than 24 hours. preserve cell viability. In addition,
Keywords: August 5% 5%
Overall, this study including 406 samples technical skills, sample quality including
Karyotyping quality indicator, bone marrow September 0% 5%
shows that we are still within the adequate volume and TLC should be
cytogenetics culture failure, hematological October 5% 5%
benchmark (i.e 5%). monitored to get a good mitotic yield.
malignancies November 2.40% 5%