WHY IS IT DONE?
Bone marrow biopsy and bone marrow aspiration offer detailed information about the condition of your bone marrow and blood cells.
Your doctor may perform a bone marrow exam to:
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- Diagnose a disease or condition involving the bone marrow or blood cells;
- Determine the stage or progression of a disease;
- Monitor the treatment of a disease.
Bone marrow biopsy and aspiration may be used for many conditions. These include:
- Blood cell conditions in which too few or too many of certain types of blood cells are produced, such as anaemia, leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, pancytopenia and polycythaemia;
- Cancers of the blood or bone marrow, including leukaemias, lymphomas and multiple myeloma;
- Cancers that have spread from another area, such as breast, into the bone marrow;
- Haemochromatosis;
- Fevers of unknown origin.
HOW YOU PREPARE
Bone marrow exams are often performed on an outpatient basis. Special preparation usually isn’t needed. However, you may want to:
- Tell your doctor about medications and supplements you take. Certain medications and supplements may increase your risk of bleeding after a bone marrow biopsy and aspiration;
- Tell your doctor if you’re nervous about your procedure. Discuss your worries about the exam with your doctor. In some cases, your doctor may give you a sedative medication before your exam, in addition to a numbing agent (local anaesthesia) at the site where the needle is inserted.
WHAT YOU CAN EXPECT
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The procedure can be done in the consultation room or in the bedroom for hospitalised patients.
Most people need only local anaesthesia, as bone marrow exam can cause brief, but sharp, pain. You’ll be fully awake during the procedure, but the aspiration and biopsy site will be numbed to reduce pain. If you feel anxious about pain, you may be given an intravenous medication so that you’re either completely or partially sedated during the bone marrow exam.
The bone marrow exam typically takes about 10 minutes. Extra time is needed for preparation and post-procedure care, especially if you receive intravenous sedation.
BONE MARROW ASPIRATION
The bone marrow fluid is usually collected from the top ridge of the back of a hipbone (posterior iliac crest). Sometimes, the front of the hip may be used. Occasionally it is collected from the breastbone (sternum) or, in children under the age of 18 months, from the lower leg bone.
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You’ll be asked to lie on your abdomen or side (or on your back if procedure is done with the sternum), and your body will be draped with cloth so that only the exam site is showing. The area where the doctor will insert the biopsy needle is marked and cleaned. The area where the sample will be taken will be “numbed” with lidocaine.
The doctor will make a small incision then insert a hollow needle through the bone and into the bone marrow. Using a syringe attached to the needle, the doctor will withdraw a sample of the liquid portion of the bone marrow. 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 will check the sample to make sure it is adequate. Rarely, fluid cannot be withdrawn and the needle is moved for another attempt.
BONE MARROW BIOPSY
The bone marrow tissue sample (biopsy) is usually collected from the top ridge of the back of a hipbone (posterior iliac crest). Sometimes, the front of the hip may be used.
Your 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. Your doctor will rotate the needle until a sample of tissue is removed. You may feel pain and pressure as the needle moves into the bone. Your doctor will then remove the entire needle and place a pressure covering over the site to prevent bleeding.
- Cortical bone
- Spongy bone
- Marrow
- Pelvis
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