By Dr Saadvik Raghuram Y
Sr. Consultant Medical & Hemato - oncologists

Published on / 27 July 2022

Article Context

  1. Overview
  2. Procedure
  3. Risks
  4. Care at Medicover
  5. Frequently Asked Questions

Overview

Bone marrow is the delicate, soft, spongy tissue found within bones. It produces the majority of the blood cells in the body. Aspiration and biopsy are diagnostic procedures used to extract a sample of bone marrow from the body for examination. In each procedure, the doctor inserts a needle into one of the bones. It is frequently performed at the back of the hip bone. The doctor then takes a bone marrow sample.

A bone marrow aspiration is the removal of a sample of fluid and cells. A bone marrow biopsy is when a solid specimen of bone marrow tissue is removed. In each case, the collected specimens are sent to a lab for examination. The procedures can be performed alone, but they are most often performed together.


Why are the procedures done?

The procedures may be performed for a variety of conditions.

  • They can aid in the diagnosis of certain blood or bone marrow infections.
  • They help to stage certain cancers like lymphoma.
  • They may aid in the detection of certain cancers, such as leukaemia.
  • They can detect whether cancer has metastasized to the bone marrow from other parts of the body.
  • They can be used to assess the efficacy of cancer treatments such as chemotherapy.
  • They may also be performed prior to certain treatments that require a bone marrow sample, such as a stem cell transplant.

Procedure

Before the Procedure

  • Bone marrow exams are frequently performed as an outpatient procedure.
  • Inform your doctor about any medications that you are taking including aspirin and other blood thinners, over-the-counter and prescription medications. You may have to discontinue some or all of them prior to the testing.
  • If you have allergies to any medications or any other food substances, inform your doctor. Also, please mention any previous reactions to medications used during other tests or procedures.
  • Tell your doctor if in the past you had bleeding problems.
  • Make arrangements to have someone drive you home after the test.

During the Procedure

  • Most patients receive only local anaesthetic for bone marrow aspiration and biopsies to block pain sensation. If you are anxious about pain, you may be given an intravenous medication that will sedate you completely or partially during the bone marrow examination.
  • A pelvic bone is frequently used for bone marrow aspiration and biopsy. It is sometimes taken from the breastbone (sternum) or, for children under the age of 12 months, from the lower leg bone.
  • If the procedure is being performed on the pelvic bone, you will be lying on your stomach or side on a hospital bed or an examination table. The doctor will use an antiseptic solution to clean the skin surrounding the bone.
  • A small needle is then used to inject local anaesthetic into the skin. The medication will be absorbed by the tissue surrounding the bone. A slight stinging sensation will occur. The area will then become numb.
  • If both procedures are required, bone marrow aspiration is usually performed first. A hollow needle is inserted into the numbed area and gently pushed into the bone by the doctor. The centre portion of the hollow needle is then removed, and a syringe is attached to the needle. The syringe is used to extract the liquid portion of the bone marrow. There will be a deep, dull, aching pain for a few seconds. The pain goes away once the needle is removed.
  • The doctor inserts a larger needle into the similar part for the bone marrow biopsy. They will insert the needle into the bone and rotate it to extract a tissue sample. As the needle inserts the bone, you may feel pain and pressure. The entire needle will then be removed by the doctor. They will then apply a bandage to the wound to prevent bleeding.

After the Procedure

After a short period of observation, you are allowed to return home. The doctor will prescribe pain medication if necessary. If you were given a sedative, you may be taken to a recovery room to rest until the effects of the sedative wears off. After that, you must be driven home by an adult family member or friend.

What are the risks of bone marrow aspiration and biopsy?

As with any other procedure, problems can occur. Some of the possible complications may include:

  • Bruising and discomfort at the biopsy site
  • Prolonged bleeding from the biopsy site
  • Infection near the biopsy site
  • Bone infection
  • Rarely bone fracture

Care at Medicover

Our team of doctors are skilled to treat blood disorders such as leukaemia, thalassemia and sickle cell disease, lymphoma, multiple myeloma and aplastic anaemia, immune deficiencies, and so on. Haematological disorders that affect blood and bone marrow in both adult and paediatric patients are treated. Medicover provides early diagnosis and proper guidance to go a long way towards successfully treating or managing haematological disorders. Oncology patients who have undergone or are planning procedures such as organ replacement and organ removal, in particular, require guidance. Medicover Hospitals is recognised in Hyderabad as one of the best bone marrow transplant hospitals.

Frequently Asked Questions:

A bone marrow aspiration is a procedure that extracts a sample of bone marrow's liquid portion. In bone marrow biopsy, a small, solid portion of bone marrow is removed.

Fatigue, pale skin, frequent or prolonged infections, easy bruising, nosebleeds, bleeding of gums, and prolonged bleeding from cuts or wounds are symptoms of bone marrow disease.

Bone marrow biopsy helps to find out blood cancers including leukaemia, lymphoma or multiple myeloma, stem cell disorders and fever with an unknown origin.

You will always receive a local anaesthetic before a bone marrow biopsy. Local anaesthesia is given by injection at the site of the biopsy to be performed. The local anaesthesia will numb the biopsy site and make the bone marrow biopsy less painful. You can also request sedation during the procedure.

The test usually takes about 30 minutes.

The posterior iliac crest is the preferred site for bone marrow aspiration and biopsy in adults.

The biopsy needle may cause a brief, dull ache. Because the inside of the bone cannot be numbed, this test may be of little discomfort. If you have a bone marrow aspiration, you may experience a brief, sharp pain as the bone marrow liquid is removed.

A haematologist or oncologist will typically perform a bone marrow biopsy in the hospital. The exam may usually take about 10 minutes, and the entire procedure takes about 30 minutes.

The scan will be reviewed by a specialist doctor, and you will receive the results within 1 to 2 weeks.

The biopsy site may be sore for several days. You may have a bruise at the site of biopsy. Walking, taking pain medication, and applying ice packs to the affected area can be beneficial. The day after the procedure, you should be able to return to work and perform your normal activities.


References:

  • https://my.clevelandclinic.org/health/treatments/22297-bone-marrow-aspiration
  • https://www.fortishealthcare.com/india/key-medical-procedures/bone-marrow-biopsy-and-aspiration-224
  • https://www.mountsinai.org/health-library/tests/bone-marrow-biopsy
  • https://www.chp.edu/our-services/cancer/resources/patient-procedures/bone-marrow-biopsy
  • https://www.childrensmn.org/educationmaterials/teens/article/12251/aspiration-and-biopsy-bone-marrow/
  • https://www.spectrumhealthlakeland.org/lakeland-ear-nose-and-throat/ent-health-library/Content/3/41353/