Hematologic Malignancies of Primary Bone Marrow Origin in Adults: The Incidence and Profile in Eleven Years From One National Tertiary Referral Hospital in Indonesia.

IntroductionThe diagnosis of adult hematologic malignancies primarily originating in the bone marrow (BM) requires comprehensive evaluation. In many cases, a definitive diagnosis necessitates referring patients from peripheral healthcare centers to tertiary hospitals. This study aimed to analyze incidence patterns and age-specific trends of such malignancies over a decade at one national tertiary hospital in Indonesia.MethodsA retrospective cross-sectional study was conducted using bone marrow aspiration (BMA) results from patients suspected of having primary BM hematologic malignancies. Procedures were performed in the Division of Hematology and Medical Oncology, Department of Internal Medicine, and analyses were conducted in the Department of Clinical Pathology at Sardjito Hospital between 2012 and 2022. Sex and age data were collected to calculate crude incidence rates (CIR), age-specific incidence rates (ASR), and age-standardized incidence rates (ASIR).ResultA total of 3,144 cases were analyzed and the results showed that the incidence of myeloid lineage malignancies was higher than lymphoid, predominantly in males. ASR showed that Myeloproliferative Neoplasms (MPN) and Myelodysplastic Syndromes (MDS) increased with age. Acute Myeloid Leukemia (AML) remained stable in younger age groups but increased significantly in older adults. Acute Lymphoblastic Leukemia (ALL) was more common in younger individuals, particularly in the 20-24 age group. Meanwhile, the incidences of Chronic Lymphocytic Leukemia (CLL) and Multiple Myeloma (MM) increased with age. A linear regression analysis of incidence trends over the years showed no statistically significant trend.ConclusionThis study provides essential epidemiological evidence on hematological malignancies of primary BM origin in Indonesia, showing the predominance of myeloid lineage malignancies and distinct age-related patterns. These findings may support age-targeted awareness, early detection strategies, and coordinated national efforts to address the growing burden of hematologic malignancies in adults.