Bone marrow examination

This is also known as bone marrow aspiration and biopsy.
In this procedure, a small sample of blood and bone marrow is taken from your bone marrow to test for certain blood (haematological) conditions.
The test is used to diagnose and monitor blood & marrow diseases such as
• Anemia
• Blood cell conditions (such as leukopenia, leukocytosis, thrombocytopenia, thrombocytosis,pancytopenia or polycythemia)
• Blood cancers (such as leukemias, lymphomas or multiple myeloma)
• Cancers which have spread from other areas into the bone marrow
• Fevers of unknown origin

Site of aspirate/biopsy (usually the pelvic bone from behind):

(image from HealthlinkBC)

How it’s done

Watch this video from Design Science which takes you through the steps on doing a bone marrow biopsy

How to prepare for the procedure
You don’t have to fast before a bone marrow examination but don’t take a heavy meal soon before the procedure.
Inform your doctor if you are taking blood thinner medication such as aspirin, clopidogrel, warfarin, dabigatran etc
You should tell your doctor or nurse also if you are allergic to local anaesthetic, plaster or any medication.

How it is done – addressing concerns
The video above takes you through the procedure but some common concerns need to be addressed,
A bone marrow is not a very painful procedure if done properly. A sedative injection would make patients calm, and the local anaesthetic injection would make the area numb. Normally there is only a small sting felt due to the local anaesthetic injection. You may feel a “suction” sensation when the marrow is aspirated.
You can drive (after the sedation has worn off) and walk normally after the procedure.
Local patients commonly mistake a bone marrow examination for a spinal or lumbar puncture which is a completely different procedure. The latter is a test done in neurological diagnosis. A bone marrow examination does not cause paralysis.

How to take care after the procedure
Keep the plaster or bandage dry for 24 hours. Do not shower, bathe, swim or use a hot tub until the next day. Avoid strenuous activity or sports for 1-2 days to avoid bleeding.
Return to see your doctor if there is
• Bleeding that soaks through the bandage or plaster
• A persistent fever
• Worsening pain or discomfort
• Swelling or increasing redness or pain at the procedure site

How long will the results take?
There are different components to the test. A simple microscopic examination will take only a couple of hours but the trephine biopsy sample may take a week to process. Flow cytometry (cell markers) commonly take about 2-3 days. Cytogenetics (chromosome analysis) may take 2 -3 weeks as it takes time for the cells to be cultured before analysis. Molecular tests take about 2 weeks.