Conflict of interest: Nothing to report.
Bone marrow biopsy in patients with hepatitis C virus infection: Spectrum of findings and diagnostic utility†
Article first published online: 1 DEC 2009
Copyright © 2009 Wiley-Liss, Inc.
American Journal of Hematology
Volume 85, Issue 2, pages 106–110, February 2010
How to Cite
Klco, J. M., Geng, B., Brunt, E. M., Hassan, A., Nguyen, T.-D., Kreisel, F. H., Lisker-Melman, M. and Frater, J. L. (2010), Bone marrow biopsy in patients with hepatitis C virus infection: Spectrum of findings and diagnostic utility. Am. J. Hematol., 85: 106–110. doi: 10.1002/ajh.21600
- Issue published online: 20 JAN 2010
- Article first published online: 1 DEC 2009
- Accepted manuscript online: 1 DEC 2009 12:00AM EST
- Manuscript Accepted: 13 NOV 2009
- Manuscript Revised: 12 NOV 2009
- Manuscript Received: 22 SEP 2009
Patients with hepatitis C virus (HCV) infection develop a number of hematologic disorders, with benign and malignant B-cell proliferations being the most common. HCV-infected patients are also prone to developing peripheral cytopenias, the etiologies of which are multifactorial and include hypersplenism and/or antiviral medications. Some of these patients may undergo bone marrow biopsy but no study has systematically recorded the bone marrow findings in this patient group. Here, we report on the range of bone marrow findings in 47 adult HCV-infected patients. These patients, who lacked concurrent human immunodefiency virus (HIV) infection, most commonly presented for a bone marrow biopsy due to abnormal peripheral cell counts. The bone marrow biopsies displayed a range of findings. Dyserythropoiesis, present in 19% of the cases, was the most common finding. Patients with pancytopenia(n = 6), as defined by current World Health Organization standards, were the most likely to have bone marrow abnormalities; two pancytopenic patients had acute myeloid leukemia, and one patient had a primary myelodysplastic syndrome. There was no correlation in bone marrow findings and antiviral medications, MELD score, cirrhosis or splenomegaly, suggesting that the degree of bone marrow dysfunction is independent of stage of HCV. The results of this study suggest that bone marrow biopsy in HCV-infected patients, even those with features of hypersplenism and/or documented antiviral therapy, can be a valid test for hematologic evaluation, especially for patients with severe pancytopenia and/or sudden alterations in peripheral cell counts. Am. J. Hematol. 85:106–110, 2010. © 2009 Wiley-Liss, Inc.