Culture failure and suboptimal analysis in cytogenetics: A data review as a quality improvement metric from a resource-limited country

Abstract

Background Conventional cytogenetic failures can affect hematological cancer diagnosis and prognosis. Resource-constrained regions without contemporary genetic testing facilities may experience this impact more. Cultural failure (CF) and suboptimal analysis (SOA) data can identify problems and set standards. Thus, a cohort was created to find areas for improvement and reduce negative contributing factors, making this cytogenetic technique more accessible and cost-effective. A retrospective study at the Cytogenetics lab of Indus Hospital, Karachi, analyzed 1234 blood and bone marrow samples from Jan 2021 to Mar 2023. CF meant no growth, while < 20 metaphases were labeled suboptimal. IBM SPSS 24.0 was used for analysis, employing chi-square to confirm factor-karyotyping associations, with p < 0.05 indicating significance. Results Of 1234 samples, 1110 (90%) were bone marrow and 124 (10%) were peripheral blood. There were 32/1234 (2.6%) CF cases; all found in bone marrow samples, making the true incidence 32/1110 (2.9%). No CF observed in peripheral blood samples tested for constitutional disorders. Additionally, chromosomal analysis quality was assessed. SOA occurred in 105/1234 (8.5%) instances, with 58% having poor morphology and 31% having a low mitotic index. Among 137 CF and SOA patients, 134/1110 (12%) were found in marrow and 3/124 (2.4%) in blood. Conclusion Lower CF rates suggest that appropriate standards and implementation of quality management protocols can reduce cytogenetic failure rates despite newly established services in a resource-constrained setting.