Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients: A Retrospective Review

Bo Liu, Joseph Limback, Melissa Kendall, Michael Valente, Jamil Armaly, Vincent Grekoski, Alex Pinizzotto, Jeremy Burt, Thomas J. Ward

Research output: Contribution to journalArticle

Abstract

Purpose To test the hypothesis that computed tomography (CT)-guided bone marrow biopsy in patients with a platelet count between 20,000/uL and 50,000/uL is safe and that preprocedure platelet transfusion is unnecessary. Materials and Methods This single-center retrospective study included bone marrow biopsies performed between May 2009 and May 2016. The study population included 981 patients—age range, 15–93 years; average age, 57 years; 505 (51.5%) men; and 476 (48.5%) women. One hundred eighty-seven biopsies were performed in patients with a platelet count of 20,000–50,000/μL; 33 were performed in patients with a platelet count of < 20,000/μL. The primary endpoint was hemorrhagic complications, Society of Interventional Radiology (SIR) complication class C or above. The complication rates in thrombocytopenic patients were compared to patients with a platelet count of ≥ 50,000/uL. Ninety-five percent confidence intervals (CIs) for the complication rate in each group were also calculated. Results There were no SIR class C or above postprocedure bleeding-related complications, including interventions or transfusions. For patients with a platelet count of < 20,000/μL and of 20,000–50,000/μL, hemorrhagic complications rates were 0% (95% CI: 0–9.1%) and 0% (95% CI: 0–1.6%), respectively. Conclusions CT-guided bone marrow biopsy is safe in thrombocytopenic patients, with a hemorrhagic complication rate below 1.6% for patients with a platelet count of 20,000–50,000/μL. Routine preprocedure platelet transfusion may not be necessary for patients with a platelet count of 20,000–50,000/μL.

Original languageEnglish (US)
Pages (from-to)1727-1731
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Platelet Count
Bone Marrow
Tomography
Biopsy
Safety
Platelet Transfusion
Confidence Intervals
Interventional Radiology
Retrospective Studies
Hemorrhage
Population

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients : A Retrospective Review. / Liu, Bo; Limback, Joseph; Kendall, Melissa; Valente, Michael; Armaly, Jamil; Grekoski, Vincent; Pinizzotto, Alex; Burt, Jeremy; Ward, Thomas J.

In: Journal of Vascular and Interventional Radiology, Vol. 28, No. 12, 01.12.2017, p. 1727-1731.

Research output: Contribution to journalArticle

Liu, B, Limback, J, Kendall, M, Valente, M, Armaly, J, Grekoski, V, Pinizzotto, A, Burt, J & Ward, TJ 2017, 'Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients: A Retrospective Review', Journal of Vascular and Interventional Radiology, vol. 28, no. 12, pp. 1727-1731. https://doi.org/10.1016/j.jvir.2017.08.009
Liu, Bo ; Limback, Joseph ; Kendall, Melissa ; Valente, Michael ; Armaly, Jamil ; Grekoski, Vincent ; Pinizzotto, Alex ; Burt, Jeremy ; Ward, Thomas J. / Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients : A Retrospective Review. In: Journal of Vascular and Interventional Radiology. 2017 ; Vol. 28, No. 12. pp. 1727-1731.
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abstract = "Purpose To test the hypothesis that computed tomography (CT)-guided bone marrow biopsy in patients with a platelet count between 20,000/uL and 50,000/uL is safe and that preprocedure platelet transfusion is unnecessary. Materials and Methods This single-center retrospective study included bone marrow biopsies performed between May 2009 and May 2016. The study population included 981 patients—age range, 15–93 years; average age, 57 years; 505 (51.5{\%}) men; and 476 (48.5{\%}) women. One hundred eighty-seven biopsies were performed in patients with a platelet count of 20,000–50,000/μL; 33 were performed in patients with a platelet count of < 20,000/μL. The primary endpoint was hemorrhagic complications, Society of Interventional Radiology (SIR) complication class C or above. The complication rates in thrombocytopenic patients were compared to patients with a platelet count of ≥ 50,000/uL. Ninety-five percent confidence intervals (CIs) for the complication rate in each group were also calculated. Results There were no SIR class C or above postprocedure bleeding-related complications, including interventions or transfusions. For patients with a platelet count of < 20,000/μL and of 20,000–50,000/μL, hemorrhagic complications rates were 0{\%} (95{\%} CI: 0–9.1{\%}) and 0{\%} (95{\%} CI: 0–1.6{\%}), respectively. Conclusions CT-guided bone marrow biopsy is safe in thrombocytopenic patients, with a hemorrhagic complication rate below 1.6{\%} for patients with a platelet count of 20,000–50,000/μL. Routine preprocedure platelet transfusion may not be necessary for patients with a platelet count of 20,000–50,000/μL.",
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T1 - Safety of CT-Guided Bone Marrow Biopsy in Thrombocytopenic Patients

T2 - A Retrospective Review

AU - Liu, Bo

AU - Limback, Joseph

AU - Kendall, Melissa

AU - Valente, Michael

AU - Armaly, Jamil

AU - Grekoski, Vincent

AU - Pinizzotto, Alex

AU - Burt, Jeremy

AU - Ward, Thomas J.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Purpose To test the hypothesis that computed tomography (CT)-guided bone marrow biopsy in patients with a platelet count between 20,000/uL and 50,000/uL is safe and that preprocedure platelet transfusion is unnecessary. Materials and Methods This single-center retrospective study included bone marrow biopsies performed between May 2009 and May 2016. The study population included 981 patients—age range, 15–93 years; average age, 57 years; 505 (51.5%) men; and 476 (48.5%) women. One hundred eighty-seven biopsies were performed in patients with a platelet count of 20,000–50,000/μL; 33 were performed in patients with a platelet count of < 20,000/μL. The primary endpoint was hemorrhagic complications, Society of Interventional Radiology (SIR) complication class C or above. The complication rates in thrombocytopenic patients were compared to patients with a platelet count of ≥ 50,000/uL. Ninety-five percent confidence intervals (CIs) for the complication rate in each group were also calculated. Results There were no SIR class C or above postprocedure bleeding-related complications, including interventions or transfusions. For patients with a platelet count of < 20,000/μL and of 20,000–50,000/μL, hemorrhagic complications rates were 0% (95% CI: 0–9.1%) and 0% (95% CI: 0–1.6%), respectively. Conclusions CT-guided bone marrow biopsy is safe in thrombocytopenic patients, with a hemorrhagic complication rate below 1.6% for patients with a platelet count of 20,000–50,000/μL. Routine preprocedure platelet transfusion may not be necessary for patients with a platelet count of 20,000–50,000/μL.

AB - Purpose To test the hypothesis that computed tomography (CT)-guided bone marrow biopsy in patients with a platelet count between 20,000/uL and 50,000/uL is safe and that preprocedure platelet transfusion is unnecessary. Materials and Methods This single-center retrospective study included bone marrow biopsies performed between May 2009 and May 2016. The study population included 981 patients—age range, 15–93 years; average age, 57 years; 505 (51.5%) men; and 476 (48.5%) women. One hundred eighty-seven biopsies were performed in patients with a platelet count of 20,000–50,000/μL; 33 were performed in patients with a platelet count of < 20,000/μL. The primary endpoint was hemorrhagic complications, Society of Interventional Radiology (SIR) complication class C or above. The complication rates in thrombocytopenic patients were compared to patients with a platelet count of ≥ 50,000/uL. Ninety-five percent confidence intervals (CIs) for the complication rate in each group were also calculated. Results There were no SIR class C or above postprocedure bleeding-related complications, including interventions or transfusions. For patients with a platelet count of < 20,000/μL and of 20,000–50,000/μL, hemorrhagic complications rates were 0% (95% CI: 0–9.1%) and 0% (95% CI: 0–1.6%), respectively. Conclusions CT-guided bone marrow biopsy is safe in thrombocytopenic patients, with a hemorrhagic complication rate below 1.6% for patients with a platelet count of 20,000–50,000/μL. Routine preprocedure platelet transfusion may not be necessary for patients with a platelet count of 20,000–50,000/μL.

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