Analysis of reference intervals of myelogram parameters used in the healthcare organizations of the Russian Federation

Introduction. Cytological examination of bone marrow aspirate is a fundamental tool in the diagnosis of hematological diseases. The reference intervals for myelogram parameters serve as the primary guide for interpreting and assessing changes in the cellular elements of bone marrow. However, the reference intervals vary in the myelogram report forms of different healthcare organizations (HCOs).

Aim. To analyze the reference values of myelograms used in “anchor” HCOs of the constituent entities of the Russian Federation.

Materials and methods. An analysis of the reference intervals for myelogram parameters used in the “anchor” HCOs of 83 constituent entities of the Russian Federation was conducted using standard methods of descriptive statistics, expert ranking, and assessment.

Results. Significant differences were identified in myelogram parameters considered as normal across different constituent entities of the Russian Federation. Reference values for myelogram parameters were absent in 1 (1.2 %) HCOs. Only 4 (4.8 %) HCOs specified the sources of their reference intervals. The remaining 78 HCOs used reference intervals from unknown sources. The analysis revealed significant disparities in the myelogram parameters accepted as normal. The upper limit for neutrophilic myelocytes varied from 10.0 % to 16.9 %, for lymphocytes from 10 % to 23.7 %, and for erythrokaryocytes from 25.0 % to 32.5 %. The permissible values for the count of blast cells in the myelogram also varied. The upper threshold for a normal blast cell count was considered ≥5 % in 7 HCOs and <1 in 5 HCOs.

Conclusion. The lack of uniform, generally accepted normal myelogram parameters complicates the diagnosis and interpretation of laboratory test results by clinicians. This article provides a brief historical overview and recommendations for standardizing reference intervals for myelogram parameters.

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