Bone marrow changes in elderly

Aim: To study the bone marrow changes in elderly patients (above 60 years of age). Material and methods: Bone marrow records from the pathology laboratory in the Department of Pathology, Bangalore Medical College, Bangalore, from March 2012 to June 2013, were searched, and cases from all patients at least 60 years old at the time of bone marrow study were retrospectively reviewed. Results: During the 16 months period, 164 bone marrow examinations were performed, and out of these, 50 patients were at least 60 years old. The age range of the patients was 60 to 82 years, 27 were males and 23 were females. 47 cases (94%) yielded specific diagnosis. 27 cases (54%) had nutritional anemia, 6 cases (12%) were diagnosed as myeloma, 3 cases (6%) had aplastic anemia, 3 cases (6%) had chronic lymphocytic leukemia/ small lymphocytic leukemia infiltrating the bone marrow; 2 cases (4%) had acute myeloid leukemia, 2 cases (4%) had hypocellular marrow with myelofibrosis - grade 3, 2 cases were diagnosed to have monoclonal gammopathy of undetermined significance (4%), 1 case (2%) had metastatic deposits from prostatic carcinoma and 1 case (2%) had metastatic deposits from renal cell carcinoma - clear cell variant; 1 case (2%) of myelodysplastic syndrome - refractory cytopenia with multi lineage dysplasia and ringed sideroblasts was diagnosed. Conclusions: In this study we found that after nutritional anemia, plasma cell dyscrasias were the most common findings in bone marrow studies in elderly patients. Diagnosis of plasma cell dyscrasias prompt for early institution of treatment resulting in reduced morbidity and mortality in such patients.