Spurious dyserythropoiesis

Abstract

We documented the occurrence and severity of dyserythropoiesis as an artifact of storage in bone marrow aspirates collected in EDTA. Bone marrow samples were obtained from 7 patients without myelodysplasia. Specimens were stored at room (20°C-24°C) or refrigerated (1°C-6°C) temperature and examined for dyserythropoiesis at 0, 1, 2, and 3 days. Initial specimens showed few dyserythropoietic abnormalities; nuclear aberrations occurred in 1.07% ± 0.06% (mean ± SEM) of the erythroid population. At room temperature, dyserythropoietic changes increased significantly with each day of storage. Nuclear and cytoplasmic alterations occurred; the former are diagnostically more important in the diagnosis of myelodysplastic syndromes. Cytoplasmic changes were more extensive than nuclear abnormalities. The mean ± SEM percentage of erythroblasts with cytoplasmic vacuoles increased with each day of storage: day 0, 1.1% ± 0.2%; day 1, 22.1% ± 1.8%; day 2, 29.4% ± 2.0%; day 3, 35.6% ± 1.9%. Nuclear shape changes increased to 6.21% ± 1.12%, 11.36% ± 1.12%, and 12.85% ± 1.20% on days 1, 2, and 3, respectively. After 1 day of storage, sufficient dysplastic changes occur to cause difficulty in the diagnosis of a myelodysplastic syndrome. Changes are inhibited significantly by refrigerated storage.