Bone marrow is the spongy, fatty tissue found inside the body's larger bones. It has liquid and solid parts. Bone marrow makes these types of blood cells: Show
Sometimes doctors need to see how well these cells develop and work. To do this, they may recommend a bone marrow aspiration and/or a bone marrow biopsy. These procedures collect a sample of bone marrow. The results of a bone marrow aspiration and/or biopsy help doctors find out about these conditions:
Doctors can also use the results from these procedures to better understand a blood cancer, including its subtype and stage, determine whether a treatment is working, and monitor any side effects of chemotherapy. What is a bone marrow aspiration and biopsy?
In both procedures, the bone marrow sample usually comes from the pelvic bone. This bone is in your lower back by your hip. Doctors often do these 2 procedures at the same time. They refer to them together as a bone marrow examination. Your doctor will decide whether you need 1 or both procedures. Who does a bone marrow aspiration and biopsy? Who analyzes the sample?An oncologist, hematologist, another doctor, or a specially trained technologist will perform the bone marrow aspiration and biopsy. A doctor who specializes in interpreting laboratory tests will look at the collected bone marrow cells under a microscope. This doctor is called a pathologist. The pathologist then gives the results to your doctor in a pathology report. Getting ready for a bone marrow aspiration and biopsyWhen you schedule your procedure, you will get a detailed explanation of how to prepare. What to eat. You can usually eat or drink normally before the test. Ask your health care team ahead of time to make sure. Topics to talk about with your health care team. You may not be able to take certain medications, such as blood thinners, before your procedure. Tell your health care team about all medications and supplements you take. Ask whether you should take them on your procedure day. You should also bring up any test concerns you have. Insurance and cost. Before your appointment, contact your insurance provider. Find out how much of the procedure’s costs it will cover and ask how much you will have to pay. Consent. The doctor's office or hospital will ask you to sign a consent form when you arrive for the procedure. This form states that you understand the procedure’s benefits and risks. The form also states that you agree to the procedure. If you have concerns about the procedure, talk with your doctor before you sign. During the procedureWhere will the procedure take place? Medical specialists do bone marrow aspiration and biopsy procedures in a hospital, clinic, or their office. How long will the procedure take? When done together, the 2 procedures usually take about 30 minutes. What happens during the procedure?You will receive a local anesthetic to block pain. You may also have the option to take medicine before the procedure to help you relax. Tell your health care team if you have ever had an allergic reaction to an anesthetic or if you are nervous. In addition to local anesthetic, your doctor may suggest conscious sedation. This type of anesthesia uses pain relievers and sedatives. Under conscious sedation, you will stay awake but feel no pain. You will also have little to no memory of the procedure. Most people only receive local anesthetic for bone marrow aspirations and biopsies. If the procedure site is your pelvic bone, you will lie on your stomach or side. You will be on an examination table or hospital bed. The medical specialist will clean the skin around the bone with an antiseptic solution. Then the specialist will inject the local anesthetic through the skin with a small needle. The medicine will go into the tissue next to the bone. You will feel a slight stinging sensation. Then the area will go numb. If you need both procedures, bone marrow aspiration usually comes first. The doctor inserts a hollow needle into the numbed area and pushes gently into the bone. Then, he or she removes the center portion of the hollow needle and attaches a syringe to the needle. The syringe withdraws the liquid portion of the bone marrow. You may feel a deep, dull, aching pain for a few seconds, similar to a toothache. It may help to squeeze a pillow or someone’s hand. After the needle comes out, the pain goes away. For the bone marrow biopsy, the medical specialist inserts a larger needle into the same area. They will guide the needle into the bone and rotate it to remove a sample of tissue. You may feel pain and pressure as the needle moves into the bone. The medical specialist will then remove the entire needle. Next, they will place a bandage over the site to prevent bleeding. After the procedureIf your procedure takes place at a clinic, you can go home shortly after it is over. But if you received sedation, you will first need to lie down for about 20 minutes. That way the medicine’s effects can wear off. You will also need a ride home after sedation. Be sure to make transportation arrangements before the procedure. What should I expect after returning home?Once you are home, keep the area around the bandage clean and dry. Ask your doctor when you can remove it. Do not shower or bathe until then. You will likely see some blood on the dressing. This is normal. You can then cover the wound with a bandage until it fully heals. You may feel discomfort at the needle insertion site. This can last for several days, especially when bending over. Some people may also feel pain down the back of their leg. Mild bruising is normal. It can show up several days after the procedure. Tell your doctor if you have any of these problems after the procedure:
Questions to ask the health care teamConsider asking these questions before you have a bone marrow aspiration or biopsy:
Related ResourcesBiopsy What Is A Bone Marrow Transplant (Stem Cell Transplant)? Donating Bone Marrow Is Easy and Important: Here’s Why More InformationMedlinePlus: Bone Marrow Aspiration MedlinePlus: Bone Marrow Biopsy You have a bone marrow test to check whether there are cancer cells in your bone marrow. Bone marrow is spongy tissue and fluid that is inside your bones. A doctor or specialist nurse removes a sample of bone marrow cells or an area of bone marrow in one piece. This is usually from your hip. A specialist doctor can then look at the cells or tissue under a microscope.  You usually have the test in the outpatient department of the hospital. You're usually awake for the test but you have a local anaesthetic to numb the area. Some people have medicine to make them drowsy (sedation). Why you might have a bone marrow testEwing’s sarcoma can sometimes spread to the bone marrow. This test checks if there are any sarcoma cells there. You may have the bone marrow biopsy at the same time as the biopsy on your bone tumour. Types of biopsyThere are 2 main types of bone marrow test – a bone marrow aspiration and a bone marrow trephine biopsy. Aspiration means the doctor or nurse sucks some bone marrow cells up into a syringe. A bone marrow trephine means that they remove a 1 or 2 cm core of bone marrow in one piece. You usually have both of these tests done at the same time. They give some of the same information to the doctor, but there are differences. The bone marrow trephine shows the structure of the bone marrow inside the bone, whereas the aspiration takes just the bone marrow cells. Preparing for your bone marrow testCheck your appointment letter for how to prepare for your bone marrow test. You are usually able to eat and drink beforehand. Take your medicines as normal. If you are taking any blood thinning medicines you might need to stop these before the test. Your doctor will tell you when to stop taking them. What happens?Your doctor or nurse gives you information about the procedure and asks you to sign a consent form. This is a good time to ask any questions you have. You change into a hospital gown and lie on your side with your knees tucked up into your chest. Usually your doctor or nurse takes the sample from the back of your hip bone. Your doctor or nurse first cleans the area with some antiseptic fluid, which can feel cold. You then have an injection into the skin over the biopsy site to numb the area. They put a thin needle through the skin into the hip bone. This might be uncomfortable but this only lasts a short time. Your doctor or nurse sucks a small amount of liquid bone marrow into the needle, using a syringe. You feel a pulling sensation when they start drawing the bone marrow cells out. They take the needle out and put in a second one if you're having a trephine biopsy as well. The aim is to get a small amount of marrow out in one piece. The whole test takes around 30 minutes. SedationSome people prefer to have some type of sedative before the test so that they are a bit drowsy. Some hospitals may use gas and air (Entonox) to help relax you instead of sedation. Children and teenagers often have sedation for this type of test. Some people might have a general anaesthetic, which means you are asleep for the test. You can't eat for 6 hours before having the anaesthetic. You might be able to have water for up to 2 hours beforehand. Your appointment letter will give you instructions about this. After your bone marrow testIf you have sedation, you need to stay at the hospital for a few hours until it has worn off. And you need someone to take you home and stay with you overnight. You usually go home the same day if you're feeling well enough. You have a dressing over the site, which you should keep on for 24 hours. Possible risks from having a bone marrow testA bone marrow test is very safe and any risks are small. During the procedure there is a very small risk of damage to nearby structures, but this is very rare. BleedingIt's not unusual to have a small amount of bleeding from the area where the needle went in. If you notice any heavy bleeding, apply pressure to the area. If it doesn't stop, contact the hospital. BruisingSometimes blood leaks out of the vein and collects under your skin. This can look like a small dark swelling under the skin (haematoma). Pressing hard once the needle is removed can help. InfectionThere is a small risk of getting an infection in the wound. Tell your doctor if you have a temperature or if the area becomes red and sore. PainSome people feel uncomfortable and have pain after the local anaesthetic has worn off. Your nurse will tell you what painkillers to take. If you have severe pain or it's getting worse then you should contact the hospital. Tingling in your legYou may have some tingling in your leg which wears off with time. Getting your resultsYour scan will be looked at by a specialist doctor and you should get your results within 1 or 2 weeks. You won't get any results at the time of the scan. Waiting for test results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact them if you haven’t heard anything after a couple of weeks. You might have the contact details for a specialist nurse. You can contact them for information and support if you need to. It may help to talk to a close friend or relative about how you feel. For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. Contact the doctor that arranged the test if you haven't heard anything after a couple of weeks. 15 Mar 2021 |
Why cant you be sedated for bone marrow biopsy
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