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Bone Marrow Biopsy

Definition

A bone marrow biopsy is the removal of a sample of bone marrow. The sample is sent for testing. The procedure is most often done on the pelvic bone. It may also be done on the sternum.
Bone Marrow Biopsy
Bone biopsy
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Reasons for Procedure

A bone marrow biopsy may be done to:
  • Evaluate a low red blood cell count (anemia), low white blood cell count (leucopenia), or low platelet count (thrombocytopenia)
  • Diagnose and stage lymphoma (tumors of the lymphoid tissues) or solid tumors
  • Diagnose, monitor, and evaluate leukemias
  • Evaluate iron level problems
  • Research unexplained spleen enlargement (splenomegaly)
  • Evaluate other blood disorders

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have this procedure, your doctor will review a list of possible complications which may include:
  • Infection
  • Bleeding
Some risk factors for complications during this procedure include:
  • Bleeding disorders
  • Infection of the skin at the biopsy site
  • Infection in the bloodstream
  • Prior radiation treatment to the biopsy site
  • Severe osteoporosis

What to Expect

Prior to Procedure

Your doctor may do a physical exam and blood tests.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Anti-inflammatory drugs
  • Blood thinners

Anesthesia

Local anesthesia will be used. It will numb the area.

Description of Procedure

You may be given a light sedative. It will help you relax. The biopsy area will be cleaned and numbed.
A hollow biopsy needle will be inserted into the bone. The needle will be twisted and moved forward. This motion will allow a sample of bone marrow to enter the core of the needle. A fair amount or pressure may be used. The needle may need to be rocked. The needle will then be removed. The bone marrow sample will be inside the needle. Pressure will be applied to the puncture area. A bandage will be applied.

Immediately After Procedure

The bone marrow specimen will be examined by a pathologist. Ask your doctor when you can expect the results.

How Long Will It Take?

About 30 minutes.

Will It Hurt?

The injection of anesthesia may sting or burn. You may notice a feeling of pressure and pain when the biopsy needle is rocked. After the biopsy is done, you may feel soreness in the area for a few hours.

Post-procedure Care

At Home
You should be able to resume your normal activities after your biopsy. If you have had a sedative, avoid driving or operating equipment until the effects of the medicine have worn off.
Follow all of your doctor's instructions.

Call Your Doctor

After you are home, contact your doctor if any of the following occur:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the biopsy site
  • Nausea and/or vomiting
  • Cough, shortness of breath, or chest pain
  • Joint pain, fatigue, stiffness, rash, or other new symptoms
In case of an emergency, call for medical help right away.

RESOURCES

The Leukemia and Lymphoma Society http://www.lls.org/

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

CANADIAN RESOURCES

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

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

References

Bone marrow biopsy. Harvard Medical School website. Available at: http://www.health.harvard.edu/diagnostic-tests/bone-marrow-biopsy.htm . Accessed January 18, 2013.

Pfenninger JL, Fowler GC. Procedures for Primary Care Physicians. St. Louis, MO: Mosby-Year Book; 1994.

Wintrobe MM, Lee GR. Wintrobe's Clinical Hematology. 10th ed. Baltimore, MD: Lippincott, Williams & Wilkins; 1999.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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