Bone Marrow Biopsy

Bone Marrow Biopsy Introduction

Bone marrow is the spongy element available inside most large bones in the body. The various cells that make blood are produced in the bone marrow. Bone marrow is the site where red blood cells, white blood cells, and platelets are formed. Other than biopsy, an aspiration (the sampling of liquid generally) is also done at the same time.

Reasons of Performing Bone Marrow Biopsy

A bone marrow aspiration and biopsy procedure is conducted for several reasons.

The test enables the physician to analyze your bone marrow performance. It may aid in the diagnosis of reduced levels of red blood cells (anemia), reduced levels of white blood cells (leukopenia), reduces levels of platelets (thrombocytopenia), or increased level of these kinds of blood cells.

The doctor can also analyze the cause of some tumors, infections, or determine at what stage the disease, such as lymphoma, has reached, and evaluate the effectiveness of chemotherapy or other bone marrow effective drugs.

Where the Procedure is Performed  

Bone marrow biopsies and aspirations can be conducted in doctor's clinics, outpatient clinics, and even in the hospitals. The procedure may stretch from 10-20 minutes.

Risks Factor Involved with Bone Marrow Biopsy

You will have to sign a declaration form prior to the procedure. You will be explained the alternatives along with the expected risks and complications of this Biopsy.
Possible risks include:

  • Persistent infection and bleeding
  • Pain, post procedure
  • Reaction to the sedative or local anesthetic

Bone Marrow Biopsy Preparation

  • You may be suggested not to eat food or drink liquids prior to the procedure.
  • Be sure to explain your healthcare professional about any prescription of medications, along with herbal supplements if you are taking any.
  • Don’t forget to explain your doctor about any allergies, earlier reactions to drugs, if you had undergone any bleeding problems earlier, or even if you are pregnant.
  • Prior to the procedure, you will be suggested to put on a patient gown.
  • Your vital components blood pressure, respiratory rate, heart rate, and temperature will be taken.
  • Depending on your physician, you may have an IV placed or your blood will be taken.
  • You may be prescribed to take some drugs to enable you relax.
  • You may be recommended to lie on your stomach or your side depending on the location the doctor chooses to use.

During the Procedure

  • The doctor will select a site to withdraw bone marrow. Mostly this is the hip (pelvic bone), but in some cases it can also be withdrawn from the breastbone (sternum), backbone (vertebra), and lower leg bone (tibia).
  • The preferred site will be cleaned with an iodine solution or alcohol. After cleaning the skin, sterile towels will be put around the area. It is vital that the sterile area is not touched once it has been sterile.
  • Local anesthetic, generally lidocaine, will be pushed into the site using tiny needle. A sting sensation may be felt initially which will be followed by a burning feeling. After a couple of minutes, the site will go stun. A needle is then put through the skin and inside the bone. You may experience a pressure sensation.
    • For the bone marrow aspiration, a small quantity of bone marrow is then taken into a syringe.
    • A bone marrow biopsy is generally conducted. A little larger needle is then put in the same site and a little sample of bone and marrow is taken again into the needle.

The wound site may bleed for some time hence some pressure is applied for a couple of minutes. A sterile bandage is then applied.

After the Procedure

If you are recommended sedative drugs, you will keep feeling drowsy for sometime. After the local anesthetic wears off in the next few hours, you may feel some uneasiness at the biopsy location. Your doctor will recommend you some pain drugs.

You have to keep the bandage on for 48 hours, and after this it can be removed.

How the Test Will Feel

You will feel a sharp sting during the injection of numbing medicine. You may experience a short, sharp pain when the liquid (aspirate) is withdrawn.
The biopsy needle may also generate a short, generally dull pain. Since the inner part of the bone cannot be numbed, this test may generate some uneasiness. However, it is not observed by all the patients.

Next Steps

The samples withdrawn from your bone marrow will be sent to a laboratory for the pathologist for evaluation. Different tests are conducted along with testing the bone marrow facilitating a microscope. The outcome of these tests will generally be delivered in a few days. Your doctor will instruct you regarding the further follow-up.

When to Seek Medical Care

You should consult your physician if you witness signs of persistent redness, continued bleeding, worsening pain, fever or if you have other problems after this procedure.