Does medullary cytology still have a place in hematology?

Background: The study of medullary cytology is essential for the diagnosis, management and follow-up of many haematological disorders. The myelogram allows a cytological analysis of the bone marrow after aspiration of the medullary sap. Objective: This work aims to determine the indications of the myelogram in our context and to review the contribution of this examination to the diagnosis process. Results: We present the results of a retrospective study, covering all myelograms performed in the hematology laboratory of Avicenna Hospital in Marrakech between May 2016 and June 2018. The prevalence of hematological diseases was 36% of all myelograms studied. The indications were dominated by disturbances of the hemogram (66%). Out of 350 cases reported, medullary plasmocytosis accounted for 15% of pathologies diagnosed against 9.5% of leukemias, 6% of megaloblastosis and 5% of myelodysplastic syndromes. Twenty-two percent of the marrow was reactive, while 31% of the samples were diluted and uninterpretable. Conclusion: The contribution of the myelogram to the diagnosis depends on a good interpretation, therefore the quality of realization. Its indication must be rational and its interpretation requires a good knowledge of the clinical and biological context.