CAPILLARY COLLECTION OF BONE MARROW SPICULES IN EDTA: A METHOD TO SALVAGE ASPIRATE SMEARS

@article{parente2026capillary,
  title = {{CAPILLARY COLLECTION OF BONE MARROW SPICULES IN EDTA: A METHOD TO SALVAGE ASPIRATE SMEARS}},
  author = {Marjori Lima Boblitz PARENTE and Edilson Diógenes Pinheiro JUNIOR and Lucas Oliveira LAURINDO and Letícia Rodrigues SAMPAIO and João Vitor Caetano GOES and Greyce Luri SASAHARA and Roberta Taiane Germano DE OLIVEIRA and Silvia Maria Meira MAGALHÃES and Ronald Feitosa PINHEIRO},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.106717},
  url = {https://doi.org/10.1016/j.htct.2026.106717},
  note = {CC BY},
}

TY  - JOUR
TI  - CAPILLARY COLLECTION OF BONE MARROW SPICULES IN EDTA: A METHOD TO SALVAGE ASPIRATE SMEARS
AU  - Marjori Lima Boblitz PARENTE
AU  - Edilson Diógenes Pinheiro JUNIOR
AU  - Lucas Oliveira LAURINDO
AU  - Letícia Rodrigues SAMPAIO
AU  - João Vitor Caetano GOES
AU  - Greyce Luri SASAHARA
AU  - Roberta Taiane Germano DE OLIVEIRA
AU  - Silvia Maria Meira MAGALHÃES
AU  - Ronald Feitosa PINHEIRO
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.106717
UR  - https://doi.org/10.1016/j.htct.2026.106717
AB  - Introduction: Bone marrow (BM) is the primary hematopoietic organ responsible for blood cell production and maturation. BM aspirate cytology is an essential diagnostic tool for the investigation of hematological disorders, including unexplained anemias, cytopenias, acute myeloid leukemia and myelodysplastic neoplasms. However, the diagnostic value of bone marrow aspirates depends largely on sample quality. Pre-analytical factors such as clot formation, hemodilution, poor cellularity, and inadequate distribution of bone marrow spicules may compromise cytomorphological evaluation and reduce diagnostic accuracy. Although the use of low concentrations of K3-EDTA to improve spicule recovery and prevent clotting is routinely applied in veterinary medicine, its application in human bone marrow cytology remains poorly investigated. Objective: Avaluate the impact of selective capillary collection of bone marrow spicules in EDTA on sample quality. Materials and Methods: We evaluated 25 BM from patients who underwent bone marrow collection via sternal manubrium puncture in a prospective, cross-sectional, descriptive study conducted between August 2025 and June 2026. Inclusion criteria comprised patients from the Geriatrics outpatient clinic of HUWC/UFC with suspected hematological abnormalities and history of environmental or occupational exposure to potentially toxic agents, aged ≥38-years, regardless of sex. Individuals who did not meet these criteria were excluded. Conventional smears prepared directly from aspirated material were compared with a modified preparation method in which 50 μL of K3-EDTA was added to the aspiration syringe before collection. Following aspiration, the sample was transferred to a Petri dish, BM spicules were selectively recovered using glass capillaries, and slides were prepared using the squash technique. This approach aimed to prevent clot formation, maximize spicule recovery, and concentrate diagnostically relevant cellular material. Results and Discussion: Slides were independently evaluated by three blinded reviewers according to cellularity, morphology preservation, spicule distribution, cell integrity, dysplastic changes, clot formation, and overall slide quality. The modified technique improved slide quality in 13 of 25 cases (52%) and demonstrated equivalent performance in 11 cases (44%). Most importantly, in 3 cases (12%), conventionally prepared smears were hypocellular and insufficient for definitive cytomorphological diagnosis, whereas the modified technique yielded adequate cellularity and enabled a definitive diagnosis. Clot formation was observed in 6 conventional samples (24%), while only 1 case (4%) showed inferior performance with the modified method because of increased hemodilution. No significant differences were observed regarding cellular morphology preservation or recognition of dysplastic features. Conclusion: The modified technique maintained cytomorphological quality while improving cellular concentration and spicule distribution in some cases. It also enabled evaluation of samples considered inadequate by the conventional method, suggesting a role in recovering non-diagnostic aspirates. As a simple and low-cost approach, selective capillary collection of bone marrow spicules in K3-EDTA may improve sample adequacy and reduce technical limitations of bone marrow aspiration. Further studies are needed to confirm its reproducibility and clinical applicability. The authors declare no conflicts of interest.
SN  - 2531-1379
SN  - 2531-1387
ER  -