What you need to know about:

Bone Marrow Aspiration and Biopsy

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Recovery Period:

1 to 2 weeks

Permanence:

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Time it takes:

30 minutes

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Anesthetize:

None

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Overview of

Bone Marrow Aspiration and Biopsy

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Bone marrow aspiration and biopsy are diagnoistic procedures carried out in order to collect and examine bone marrow: the spongy tissue inside some of your larger bones. These procedures can show whether your bone marrow is healthy and produces normal amounts of blood cells. Doctors use these procedures to diagnose and monitor blood and marrow diseases, including some cancers.

Goals of

Bone Marrow Aspiration and Biopsy

A bone marrow exam offers detailed information about the condition of your bone marrow and blood cells. Your doctor may order a bone marrow exam if blood tests are abnormal or don't provide enough information about a suspected problem. Your doctor may perform a bone marrow exam to: -Diagnose a disease or condition involving the bone marrow or blood cells -Determine the stage or progression of a disease -Determine whether iron levels are adequate -Monitor treatment of a disease -Investigate a fever of unknown origin A bone marrow exam may also help the doctor diagnose you whether you may have the following conditions: -Anemia -Blood cell conditions in which too few or too many of certain types of blood cells are produced, such as leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, pancytopenia and polycythemia -Cancers of the blood or bone marrow, including leukemias, lymphomas and multiple myeloma -Cancers that metastasized into the bone marrow -Hemochromatosis -Fevers of unknown origin

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Bone Marrow Aspiration and Biopsy

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Pros and cons of

Bone Marrow Aspiration and Biopsy

Pros

-Bone marrow aspirate and culture is superior to blood culture, since the bacterial concentration in bone marrow is 10 times that of peripheral blood.

Cons

-Since the contents of the bone marrow may vary in different regions, an aspiration and biopsy done in one region may not be representative of the whole or may miss focal areas of bone marrow involvement with tumor or other conditions. The technique is also dependent on the skill of the physician performing the procedure and the quality of the samples obtained.

-Since bleeding is the most common side effect of the procedure, it may be challenging when a person has a low platelet count.

How it works:

Bone Marrow Aspiration and Biopsy

A bone marrow examination is normally performed only local anesthesia to numb the area where the needles will be inserted. With local anesthesia, bone marrow aspiration, in particular, can cause brief, but sharp, pain. Many people choose to also have light sedation for additional pain relief. You may be given an IV medication so that you're either completely or partially sedated during the bone marrow exam. The area where the biopsy needles will be inserted is marked and cleaned with an antiseptic. The bone marrow fluid (aspirate) and tissue sample (biopsy) are usually collected from the top ridge of the back of your hipbone (posterior iliac crest). Sometimes, the front of the hip may be used. Rarely, bone marrow aspiration — but not biopsy — is collected from the breastbone or, in children under the age of 12 to 18 months, from the lower leg bone. The bone marrow aspiration is usually done first. The doctor will make a small incision in the skin, followed by an hollow needle through the bone and into the bone marrow. Using a syringe attached to the needle, a sample of the liquid portion of the bone marrow is withdrawn. You may feel a brief sharp pain or stinging. The aspiration takes only a few minutes. Several samples may be taken. The health care team checks the sample to make sure it's adequate. Rarely, fluid can't be withdrawn and the needle is moved for another attempt. When performing a bone marrow biopsy, the doctor will use a larger needle to withdraw a sample of solid bone marrow tissue. The biopsy needle is specially designed to collect a core (cylindrical sample) of bone marrow.

Preparation before

Bone Marrow Aspiration and Biopsy

Pre - treatment

Bone marrow exams are often performed on an outpatient basis. Special preparation usually isn't needed. If you'll be receiving a sedative during the bone marrow exam, your doctor may ask you to stop eating and drinking for a period of time before the procedure. You'll also need to make arrangements for someone to drive you home afterward. You will also discuss with your doctor about medications and supplements you take. Certain medications and supplements may increase your risk of bleeding after a bone marrow aspiration and biopsy.

Recovery after

Bone Marrow Aspiration and Biopsy

Post - treatment

Pressure will be applied to the area where the needle was inserted to stop the bleeding. A bandage will then be placed on the site. If you had local anesthesia, you'll be asked to lie on your back for 10 to 15 minutes and apply pressure to the biopsy site. You can then leave and go about your day, returning to normal activity as soon as you feel up to it. If you had IV sedation, you'll be taken to a recovery area. Plan to have someone drive you home, and take it easy for 24 hours. You may feel some tenderness for a week or more after your bone marrow exam. Ask your doctor about taking a pain reliever, such as acetaminophen (Tylenol, others).

Risks & side effects

Bone marrow exams are generally safe procedures.

Complications are rare but can include: -Bruising and discomfort at the needle insertion -Excessive bleeding, particularly in people with low numbers of a certain type of blood cell (platelets) -Infection, generally of the skin at the site of the exam, especially in people with weakened immune systems -Long-lasting discomfort at the bone marrow exam site -Rarely, penetration of the breastbone (sternum) during sternal aspirations, which can cause heart or lung problems

FAQs:

Bone Marrow Aspiration and Biopsy

How painful is a bone marrow biopsy?

Most people need only local anesthesia, as bone marrow aspiration, in particular, can cause brief, but sharp, pain. Individuals are fully awake during the procedure, but the aspiration and biopsy site will be numbed to reduce pain.

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What does a bone marrow biopsy show?

The biopsy will determine whether there is evidence of cancer in the bone marrow which changes the stage and treatment of the cancer/lymphoma. The test also reveals how well you are producing white blood cells, red blood cells and platelets.

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What are the indications for a bone marrow biopsy?‍

A bone marrow biopsy may be done for the following reasons: -To uncover a reason for an abnormal level (high or low) of red blood cells (anemia or polycythemia), white blood cells (leukopenia or leukocytosis), or platelets (thrombocytopenia or thrombocytosis). While a complete blood count can detect abnormal levels of blood cells, the results do not explain why the levels are high or low. -To evaluate a fever of unknown origin (a fever that persists without any obvious cause) -To investigate abnormal bleeding or clotting -To diagnose, further evaluate, or subtype known cancers that begin in the bone marrow, such as leukemias and lymphomas, when there are not enough circulating cancer cells to make the diagnosis otherwise -To see if some cancers have spread to the bone marrow -To follow the progress of a cancer or bone marrow disease, either to decide when to initiate treatment or to monitor the results of treatment -To evaluate iron overload conditions and monitor iron levels -To identify stem cell disorders and some rare genetic syndromes

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