Bone Marrow Biopsy and Aspiration

bone marroe biopsy

Bone marrow is the spongy tissue and fluid which is inside some of the larger bones in the body. The marrow is where you make red blood cells, white blood cells, and platelets from cells called 'stem cells'.

A biopsy is where a small sample of tissue is removed from a part of the body. The sample of tissue is then examined under the microscope to look for abnormal cells, and may also be tested in other ways.

Aspiration means removing some fluid. In this example it is the removal of a sample of bone marrow fluid which can be looked at under the microscope or tested in other ways.

Who has a bone marrow biopsy and aspiration?

The common reasons are:

  • Find the reason for a low number of red blood cells (anaemia), a low number of white blood cells (leukopenia), or a low number of platelets (thrombocytopenia) in the blood.
  • Various types of leukaemia.
  • Various other types of blood disorders.
  • Monitor the response of treatment for leukaemia.
  • Determine how far certain lymphomas or cancers have progressed.

How are these tests done?

Bone marrow samples are usually taken from the top of the pelvis bone. This is the bone that you can easily feel just below each side of your waist. Occasionally, other large bones are used, such as the sternum (breastbone).

The skin over the bone to be sampled is cleaned with antiseptic. Some local anesthetic is then injected into a small area of skin and tissues just over the bone. Some people are given a sedative before the procedure.

To aspirate bone marrow fluid a needle is pushed through the anaesthetized skin into the bone. A syringe is used to draw out some liquid bone marrow.

To biopsy the bone marrow a second, thicker, hollow needle is inserted into the bone. This is rotated around as it is pushed slightly forward to force a small sample of bone marrow into the hollow middle of the needle. This may cause some dull pain.

After the test

You will need to lie on a bed and be observed for an hour or so to check you have had no serious bleeding. You may have some discomfort and bruising over the test site for a few days, which you can ease by taking painkillers.

What preparation is needed before the test?

You may need a blood test shortly before these tests to check how well your blood will clot. This is to make sure that you are not likely to bleed much. If you take medicines that affect blood clotting, such as aspirin or warfarin, you may be advised to stop taking these, or to reduce the dose, for one week before the test.

What are the risks of bone marrow biopsy and aspiration?

Complications are uncommon. In a small number of cases, there is some bleeding from the biopsy site. This is usually minor, and usually soon stops. Occasionally, the bleeding is more severe and, rarely, it requires a blood transfusion to deal with it. There is a small risk that the small wound will become infected after the biopsy. Procedure related complications like injury to nearby structures are rare.

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