Bone Marrow Biopsy and Aspiration

What is a bone marrow biopsy and aspiration?

A bone marrow biopsy and aspiration is a procedure for removing samples of tissue from the center of a bone for tests. Bone marrow is spongy tissue in the center of bones. It produces red blood cells, white blood cells, and clotting cells called platelets.

The test results show whether the various types of blood cells are present in normal amounts and are developing normally. Too many or too few of certain types of cells may indicate specific diseases. The test also gives information on some blood functions, such as clotting.

When is it used?

A bone marrow biopsy helps diagnose blood disorders. These include:

• low levels of red blood cells (anemia)
• low levels of white blood cells or platelets
• blood cell cancers, such as leukemia, and some other types of cancer
• infections
• side effects of cancer therapy.

How do I prepare for this procedure?

There are no restrictions for eating or drinking before the test. If you will be having a sedative, find someone to drive you home after the test.

If you need a minor pain reliever in the week before the test, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during the procedure. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before the test. Make sure your provider knows about any medicines, herbs, or supplements that you are taking.

What happens during the procedure?

You will be given a local anesthetic at the biopsy site to numb your skin and the tissue under your skin. You may also be given a sedative to help relax you during the test.

Your provider will make a small cut in the skin. A needle will then be passed through the cut and into the bone. The most common area used to get the samples is the back side of the pelvic bone. Rarely the breast bone may be used. You may feel pressure when the needle is inserted. Your provider may take 2 samples. The first sample, called aspirate, will be liquid bone marrow that is suctioned into a syringe. The second sample, called a core biopsy, will be a small solid piece of bone marrow. You may have a few seconds of a brief, uncomfortable, pulling feeling when the marrow is removed, especially during the suctioning.

The entire procedure usually takes only 10 to 15 minutes.

What happens after the procedure?

Unless your provider tells you otherwise, there are no special steps to take after the procedure. You may have some soreness and bruising at the biopsy site for a few days. Ask your health care provider when and how you will get the results of the exam.

What are the benefits of this procedure?

Lab tests of the bone marrow samples may help your provider diagnose your problem.

What are the risks associated with this procedure?

This procedure has very few risks. It is not harmful to your bones or marrow.

• The local anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.
• You may have bleeding.
• You may develop an Infection internally or where the needle was inserted.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

After the procedure, call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You have bleeding, redness, swelling, or any unusual drainage from the biopsy area.
• You have a rapid pulse.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.