The utility of bone marrow examination in renal transplantation: nine years of experience from north India

Renal transplantation may be complicated by persistent fever and cytopenia. Bone marrow examination, though painful and invasive, may be of value because it can be performed in most peripheral hospitals, and the results are rapidly available. In a retrospective analysis, clinical records, marrow aspirates, and trephine biopsies were assessed to determine the indications for bone marrow examination and the findings in 132 patients over a 9-year period. In 7 of 61 (11%) patients with fever, a specific infection or a malignancy was identified, and hypocellularity was seen in 85% of cases. Nutritional deficiency with megaloblastosis or diminished iron stores was noted in 29% of cases. Malignancies were relatively infrequent (3%). Overall, in 12% of the cases, bone marrow examination provided useful information. Examination of the bone marrow may be a useful diagnostic test in pyrexia of unknown origin and cytopenia, particularly in developing countries.