THE CELLULAR COMPOSITION OF NORMAL BONE MARROW AS OBTAINED BY STERNAL PUNCTURE

Abstract

Knowledge of the normal anatomy and physiology of bone marrow is still scanty because studies in the field are neither numerous nor standardized. The authors devote the bulk of their review to critique of the methods of study available; and to variables which affect the composition of normal specimens, such as site and technic of puncture or section, amount of material necessary, preparation of marrow for examination, selection of subjects, criteria of cell identification, statistically unavoidable errors in cell counting and other sources of error. They then tabulate such total and differential cell counts (per cmm. of sternal marrow) in adults and children as can be reduced to common terms from the literature, and cull from these a table of tentative normal standards. They add that, "notwithstanding the limitations which have been pointed out and the lack, as yet, of accurate normal standards, the widespread use of sternal puncture is a testimonial to its value in the differential diagnosis of aleukemic and subleukemic leukemias, aplastic anemia, other puzzling anemias, malaria, leishmaniasis, multiple myeloma, and the lipid histiocytoses, and to the value of bacteriologic cultures of marrow in subacute bacterial endocarditis and other bacteriemias.".