Bone Marrow Test

Bone marrow biopsy and bone marrow aspiration are procedures performed to diagnose and monitor blood and marrow diseases, often to find out if cancer or infection has spread to the bone marrow. A bone marrow biopsy removes a small amount of bone, fluid, and cells from inside the bone (bone marrow), while a bone marrow aspiration removes only the marrow.

What are Bone Marrow Biopsy and Bone Marrow Aspiration?

Bone marrow biopsy and aspiration refer to the diagnostic procedures performed to collect a sample of the bone marrow. The bone marrow is a soft, spongy tissue present in some larger bones of the body.

Bone marrow biopsy and aspiration are recommended for the detection of the abnormalities related to the bone marrow. This test can help to assess whether the bone marrow is healthy and produces the normal amount of different blood cells.

These tests are also advised for monitoring blood and bone marrow diseases such as cancers and a fever of unknown origin.

The bone marrow consists of two different portions of which one is fluid in consistency and the other is solid. During bone marrow biopsy, the doctor inserts a needle into the bone to withdraw a small sample of the solid portion. The bone marrow aspiration involves the aspiration of the fluid portion of the marrow using a needle.

Usually, both the bone marrow biopsy and aspiration are done at the same time. Together, these procedures are referred to as the bone marrow examination.

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Why is a Bone Marrow Biopsy or Bone Marrow Aspiration required?

The indications for bone marrow biopsy and aspiration include:

● Diagnosis of a disease affecting the bone marrow and blood cells ● Determine the extent of progress or stage of a disease such as cancer ● Monitor the response of the patient to the treatment of bone marrow diseases ● For the diagnosis of the fever of unknown origin .

The diseases which can be diagnosed with the help of bone marrow biopsy and aspiration include:

● Blood cell disorders like leucopaenia, thrombocytopaenia, thrombocytosis, leucocytosis, polycythemia, and pancytypaenia ● Haemochromatosis ● Cancers that have spread from the breasts or other tissues to the bone marrow .

What are the risks involved in the procedures?

Bone marrow examinations are generally considered safe. In some cases, patients may develop a few side effects such as:

● Pain and discomfort at the site of biopsy ● Infections, especially in patients with a weak immune system ● Excessive bleeding, especially in patients with a reduced platelet count .

How should I prepare for a Bone Marrow Biopsy and Bone Marrow Aspiration?

● It is vital to inform your doctor of any allergies you may have and discuss your medications prior to the procedure. ● Patients should inform the doctor if they are using any medications or supplements that can increase the risk of bleeding after the procedure. ● Discuss your concerns about the procedure with the doctor to avoid anxiety. In some cases, the doctor may give you a sedative before the procedure to reduce anxiety. .

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How will my doctor perform the procedure?

Bone marrow examinations are usually performed in a hospital, or on an outpatient basis. The bone marrow examination typically takes about 10 to 15 minutes. The procedures are usually performed by a doctor who specialises in the treatment of blood disorders (haematologist).

Before the procedure

A local anaesthetic agent is administered to prevent pain during the procedure.

The area where the biopsy needle is to be inserted is cleaned. Then, a small amount of the bone marrow fluid is aspirated through a needle and a tissue sample is collected from the upper ridge of the back of the hipbone. The sample may also be collected from the front of the hip.

Usually, the bone marrow aspiration is done first. The doctor will gently insert a needle through the bone to reach the bone marrow. One or more samples of the liquid portion of the bone marrow are aspirated through a syringe attached to the needle. You may feel a sharp pain at this step. The aspiration takes just a few minutes.

The collection of the solid portion of the bone marrow requires a larger needle. The bone marrow biopsy needle is specifically designed to facilitate the collection of the core of the bone marrow.

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What happens after the procedure?

Mild pressure is applied at the site of the procedure to stop the bleeding, after which a bandage is placed on the site. You will be asked to rest and lie down on your back for about 20-30 minutes.

Patients are usually allowed to resume their routine activities after the procedure. However, if the procedures are performed under intravenous (IV) sedation, you will be advised to avoid driving or strenuous activities for at least 24 hours after the procedure.

You may experience mild pain and tenderness at the site of the procedure for 5 to 7 days. You can take a dose of a pain reliever like paracetamol to reduce the pain.

The bandage must be kept dry for 24 hours to prevent infections. Hence, it is advisable to avoid taking a shower, bathe or swim for 24 hours after the procedures.

Do contact your healthcare provider promptly if you experience persistent or spreading redness, bleeding at the site, fever, or increasing pain.

What happens with my collected samples?

The samples collected during the bone marrow examination will be sent to a laboratory. A haematologist or a pathologist will perform an analysis of the samples to determine if the bone marrow is healthy and producing healthy blood cells.

The samples are also analysed for the detection of abnormal cells, the information can help in the diagnosis of blood or bone marrow disorders. It will also help to evaluate whether a treatment is working and determine the progress of the disease. Depending on the results, your doctor may advise follow-up tests to confirm or rule out the diagnosis.

Disclaimer: The information on the Centre For Clinical Haematology website is intended for educational use. It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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