Definition

A bone marrow biopsy is the removal of a sample of bone marrow for testing.

	Bone Marrow Biopsy
	© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

The procedure is most commonly performed on the pelvic bone, but is sometimes done on the sternum.

Reasons for Procedure

In response to an abnormal blood test (one revealing too many or too few red blood cells, white blood cells, or platelets), a bone marrow biopsy is performed for the:

• Evaluation of unexplained anemia , low white cells count (leucopenia), low platelets count (thrombocytopenia)
• Diagnosis and staging of lymphoma (tumors of the lymphoid tissues) or solid tumors
• Diagnosis, monitoring and evaluation of leukemias
• Evaluation of iron metabolism and stores
• Evaluation of fever of undetermined origin
• Investigation of unexplained splenic enlargement (splenomegaly)
• Evaluation of suspected chromosomal disorders in neonates
• Confirmation that the bone marrow is normal in a potential bone marrow donor

Risk Factors for Complications

• Bleeding disorders
• Infection of the skin overlying the area from which the biopsy is to be taken
• Infection in the bloodstream
• Previous radiation treatment to the biopsy site
• Severe osteoporosis

What to Expect

Prior to Procedure

Your physician will perform a physical exam and blood tests.

During Procedure

Anesthesia and possibly, a light sedation will be administered.

Anesthesia

Local anesthesia is used for bone marrow biopsies.

Description of the Procedure

Just before the procedure, you may be given a light sedative to help you relax. The area of your pelvis from which the biopsy will be taken is cleaned with an antiseptic, and numbed with a local anesthetic.

A hollow biopsy needle is inserted into the bone, and simultaneously advanced and twisted, to force a sample of bone marrow into the core of the needle. The doctor may need to use a fair amount of pressure and may need to rock the needle to get a sufficient sample. As the needle is withdrawn, the bone marrow sample is extracted. After the needle is removed, pressure and then a bandage are applied over the area that was punctured.

After Procedure

The bone marrow specimen will be examined by a pathologist.

How Long Will It Take?

The procedure typically takes about 30 minutes.

Will It Hurt?

The injection of local anesthetic may sting or burn. You may notice a sensation of pressure and/or pain as the biopsy needle is rocked to obtain the sample.

Possible Complications:

• Infection
• Bleeding

Average Hospital Stay

The test may be performed in your doctor's office, and you can go home afterwards. A hospital stay is not necessary

Postoperative Care

You should be able to resume your normal activities after your bone marrow biopsy. If you have had a sedative, you'll be advised to avoid driving or operating equipment until the effects of the medication have worn off.

Outcome

The pathologist will give your doctor information about the bone marrow, which will help your doctor make a diagnosis.

Call Your Doctor If Any of the Following Occurs

• Severe pain
• New onset of pain more than 24 hours after the procedure has been completed
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the biopsy site
• Signs of infection, including fever and chills

RESOURCES:

National Cancer Institute, National Institutes of Health
http://www.cancer.gov

The Leukemia and Lymphoma Society
http://www.leukemia.org/hm_lls

CANADIAN RESOURCES:

BC Cancer Agency
http://www.bccancer.bc.ca/

Cancer Centre of Southeastern Ontario
http://www.krcc.on.ca/

References:

Bone marrow biopsy. National Institutes of Health website. Available at: wwwnlm.nih.gov/medlineplus/ency/article/003934.htm . Accessed October 30, 2006.

Procedures for Primary Care Physicians . Mosby-Year Book;1994.

Wintrobe's Clinical Hematology . 10th ed. Lippincott, Williams & Wilkins;1999.

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