Abstract

This prospective study compared serum ferritin and bone marrow trephine iron
studies with the results of bone marrow aspirate Perl’s stain in consecutive adult
patients presenting at the haematology ward and requiring marrow studies.
Sixty patients, 35 males (58%) and 25 females (42%), with a mean age of 44 ±
4 years were recruited into the study. Thirty-four (56%) of the patients had human
immunodeficiency virus (HIV) infection while the remaining 26 had chronic myeloid
leukemia (CML), non-Hodgkin’s lymphoma (NHL), severe anaemia or hyperreactive
malarial splenomegaly (n = 13, 7, 4 and 2 respectively).
Full blood counts (FBC), red cell indices, ESR, blood film microscopy (for
malaria parasites and blood cells morphology), ELISA-based serum ferritin
concentration (sFC) and bone marrow aspiration (and trephine biopsy, if aspirate is
aparticulate) were done. All parameters were analysed for correlation to the sFC
values and a p-value < 0.05 was considered significant.
There was no statistical difference in the sFC of patients analysed according to
age, sex, diagnosis, or ESR. However, the sFC of anaemic patients (PCV ≤ 30%)
were significantly higher than those of the non-anaemic. Also, the difference in the
sFC of (bone marrow) aspirate-negative and aspirate-positive patients was significant;
and further enhanced with ESR adjustment of the sFC. Bone marrow trephine biopsy
iron studies correlated acceptably with aspirate Perl’s stains in 78% of cases and
helped to diagnose iron adequacy in 31% of patients with hypogranular aspirates.
The study has shown a clear correlation between serum ferritin values and
bone marrow studies; and the possibility of enhancing its predictive value with an
ESR in patients with inflammatory conditions and malignancies.

STORAGE IRON STATUS: A COMPARISON OF SERUM FERRITIN, BONE MARROW ASPIRATE AND TREPHINEBI