Bone marrow aspiration and biopsy

Bone marrow aspiration and biopsy is a diagnostic procedure commonly performed in medicine to evaluate and diagnose various blood disorders, bone marrow disorders, and certain cancers. It involves the collection of a small sample of bone marrow from the hipbone or sternum for examination under a microscope.

Bone marrow is the soft, fatty tissue located inside the larger bones of our body. It consists of both liquid and solid components. This essential tissue is responsible for producing three types of blood cells:

  • Red blood cells, which transport oxygen to all parts of the body.
  • White blood cells, which aid the body in fighting infections and diseases.
  • Platelets, which play a crucial role in blood clotting and controlling bleeding.

Bone marrow aspiration is a procedure that takes a sample of the liquid part of the bone marrow, while a bone marrow biopsy removes a small, solid piece. Both procedures typically use the pelvic bone in the lower back near the hip as the source of the bone marrow sample.

While bone marrow aspiration can be performed independently, it is commonly conducted with a biopsy. Together, these procedures are often referred to as a bone marrow examination.

Who conducts bone marrow aspiration and biopsy?

A bone marrow aspiration and biopsy can be performed in a hospital or clinic. These procedures are usually performed by a hematologist (specialist in blood disorders) or an oncologist (cancer specialist). Additionally, nurses with special training may also conduct bone marrow exams. The entire bone marrow exam usually takes about 10 to 20 minutes. However, extra time is required for preparation and post-procedure care, mainly if intravenous (IV) sedation is administered.

After the procedure, a pathologist, who is a doctor specializing in interpreting laboratory tests, examines the collected bone marrow cells under a microscope. The pathologist prepares a pathology report containing the results of the analysis.

Why bone marrow aspiration and biopsy is performed?

Bone marrow aspiration and biopsy

  • Help diagnose various blood disorders, including leukemia, lymphoma, and myeloma. They can also detect infections, anaemia and monitor treatment response.
  • In cancer patients, these procedures help determine the disease’s stage and monitor the treatment’s effectiveness.
  • Investigate a fever of unknown origin.

How are bone marrow aspiration and biopsy performed?

Preparing for the procedure

Bone marrow exams are usually done on an outpatient basis without the need for special preparation.

If a sedative is planned for the exam, the doctor may ask to stop eating and drinking for some time before the procedure.

It is important to inform the doctor about any medications or supplements the patient is taking as some of them may increase the risk of bleeding during the bone marrow aspiration and biopsy.

During bone marrow aspiration and biopsy

A local anesthetic is used to numb the skin and underlying tissues near the procedure site.

A thin needle is inserted into the bone, usually, the hipbone or sternum, to withdraw a small amount of liquid bone marrow.

After the aspiration, a larger needle is used to extract a small core of bone marrow along with a tiny piece of bone.

The samples are sent to a laboratory for analysis.

After the bone marrow exam, pressure will be applied to the needle insertion site to stop bleeding, followed by the placement of a bandage.

If local anesthesia is used, the patient will be asked to lie on the back for about 10 to 15 minutes while applying pressure to the biopsy site. The patient can resume normal activities as soon as they feel ready.

If the patient has had IV sedation, they will be taken to a recovery area until the effects of the sedation wear off.

It is normal to experience tenderness for about a week after the bone marrow exam. If needed, ask the doctor about using a pain reliever medication. Avoid exercise or any strenuous physical activity for at least 24 hours. Wear the bandage and keep it dry for 24 hours.

Bone marrow aspiration and biopsy are generally safe. However, there is a small risk of bleeding, infection, or damage to surrounding tissues.


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