The most frequent site for obtaining bone marrow is the
pelvic bone, known as the ilium. A portion of this bone is readily
accessible in most people from the lower back and is usually marked
by shallow dimples on either side of the spine. Other sites include
the front of the pelvic bone near the groin and the sternum
at the front of the chest.
Typically, only a local anesthetic is required to numb the skin
and tissue down to the surface of the bone. A small cut (less than
one-quarter inch) is then made in the skin. A special needle is used to
penetrate through the dense outer shell of bone. Once inside the
bone, the center portion of this needle (the trochar) is removed and
a syringe is attached. The bone marrow is withdrawn by pulling back
on the plunger of the syringe and collecting the liquid. This sample
is known as the marrow aspirate. This part of the procedure only
lasts a few seconds, but is usually the most painful due to the sudden
stimulation of small nerves inside the bone.
A biopsy can also be obtained in addition to the marrow aspirate
or when an aspirate cannot be obtained. The same needle is used but
without the center portion in place. As the needle is twisted through
the bone it cuts a core which is trapped inside the needle. Once
the needle is removed, this core can be extracted from the needle
barrel. This core can then be prepared with fixatives and stains for examination under a microscope.
Since the skin cut for a bone marrow procedure is usually very small, no stitches are
generally necessary and only a bandage is applied.
The bone marrow core biopsy is first placed in a liquid that
keeps the cells in their natural condition (fixative solution). The
sample is then placed in a solution to soften the bone and is finally processed
like other biopsies in the tissue study (histology) laboratory. The
liquid portion of the bone marrow is spread on glass slides and
stained to make the bone marrow smears. The slides are then examined
under the microscope, usually by a specially qualified technician or
physician such as a hematologist or pathologist.
Portions of either sample may be submitted to the microbiology
laboratory for cultures. Certain conditions may require other
specialized studies such as genetic testing or cell marker
studies.
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
In the U.S., more than 2,000 people are diagnosed with bone cancer every year. There are many types of bone cancer. The most common forms of bone cancer are osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma. Pain is the most common symptom. Treatment usually involves surgery, chemotherapy, and radiation therapy.
Non-Hodgkin's lymphoma is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain. Treatment depends on which type of non-Hodgkin's lymphoma you have, the stage of the cancer, your age, how fast the cancer is growing, and whether you have other health problems.
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
Hodgkin's disease is a cancer of the lymphatic system with symptoms that include unexplained, recurring fevers, unexplained weight loss, itchy skin, and painless swelling of the lymph nodes in the neck, underarm, and groin. Treatment for adult Hodgkin's disease depends on the staging of the disease, the lymph nodes' size, and the health of the patient.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staning granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis.
Alpha thalassemia is a disorder in which the alpha globin protein is underproduced. There are two pairs of genes that carry the code for the alpha chains of hemoglobin. When one gene is impaired, that person is in a carrier state and suffers no medical problems. When four genes are impaired, the production of fetal and adult hemoglobin is prevented, resulting in hydrops fetalis and leading to death before birth.
Neuroblastoma is a type of cancer that usually afflicts children under 5 years of age. The cancer forms in the adrenal glands, neck, chest, or spinal cord. Symptoms include bulging eyes, bone pain, dark eye circles, a lump in the neck, chest, or abdomen, weakness, or swollen stomach. Treatment depends upon the risk group, which is determined by staging, the child's age, tumor histology, and the tumor biology.
Stem cells are referred to as undifferentiated cells due to the fact that they have not yet committed to a developmental path to form specific organ tissue. There are a variety of types of stem cells to include embryonic, fetal, adult peripheral blood, umbilical cord, and induced pluripotent stem cells.
Childhood acute lymphoblastic leukemia is the most common type of cancer in children. Symptoms and signs include fever, easy bruising, bone or joint pain, weakness, loss of appetite, and painless lumps in the neck, underarm, stomach, or groin. Treatment depends upon staging and may include chemotherapy, radiation, or stem cell transplant.
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