Bone marrow is a spongy tissue within the bones. It is present inside the hip bone, ribs, sternum, and thigh bone. It is a semisolid tissue containing fluid and solid portions. Bone marrow contains stem cells that produce blood cells:
- White blood cells (WBCs): fight against infections
- Red blood cells (RBCs): carry oxygen and nutrients
- Platelets: responsible for blood clotting
Bone marrow biopsy and aspiration are procedures usually performed together to collect and examine bone marrow for helping in the diagnosis of blood disorders and other conditions. In a bone marrow biopsy, a special biopsy needle is used to extract a sample of the solid portions of the bone marrow. In bone marrow aspiration, a special aspiration needle is used to withdraw (aspirate) a sample of the fluid portion.
Why is bone marrow biopsy and aspiration done?
Bone marrow analysis is one of the most important diagnostic tools for evaluating blood disorders and other conditions. It helps in the diagnosis, staging, and therapeutic monitoring of blood cancers. Some common conditions that indicate bone marrow biopsy and aspiration are:
- Chronic myeloid leukemia and acute myeloid leukemia: Cancer arising from myeloid cells in the bone marrow which form WBCs (white blood cells), RBCs (red blood cells) and platelets
- Acute lymphocytic leukemia and acute lymphocytic leukemia: Cancer arising from the lymphocyte cells, a type of WBC present in the bone marrow
- Hodgkin and non-Hodgkin lymphoma (cancer of the lymphatic system)
- Hairy cell leukemia (slow growing cancer of B cells, a type of WBC)
- Multiple myeloma (cancer of plasma cells, also called B cells, a type of WBC)
- Idiopathic thrombocytic purpura (low level of platelets due to an unknown cause)
- Cytopenia (decreased level of one or more blood cell types)
- Thrombocytosis (increased level of platelets)
- Undiagnosed anemia (decreased RBCs)
- Nutritional deficiencies
- Infections that may infiltrate the bone, e.g., tuberculosis and fungal infections.
- Fever of unknown origin
- Metastatic cancer (cancer that has spread to other parts of the body)
- Metabolic disorders
What happens during bone marrow aspiration and biopsy?
The most commonly used bone for a biopsy is the iliac crest (thick curved upper border of the hip bone, present on both sides of the hip). It is easily accessible and associated with lesser complications. A biopsy sample may be obtained from one or both iliac crests. Sampling from the iliac crest may be contraindicated in obese patients.
The sternum (breastbone) is sampled as the last resort in those older than 12 years of age and in those who are obese. Sternum has a higher risk of complications.
The tibia (shin bone) is sampled in infants aged younger than one year.
Before the procedure:
The doctor obtains a detailed medical history, performs a physical assessment, and advises complete blood and radiological analysis to understand the disease better. Biopsy helps in confirming the diagnosis.
During the procedure:
It is a short procedure performed under local anesthesia. Children or patients who do not cooperate require general anesthesia or intravenous sedation. Hence, there is no pain. Bone marrow aspiration to extract fluid portion of the marrow is usually performed first. A small incision is made through which an aspiration needle is inserted into the bone and then into the bone marrow. Following this, bone marrow biopsy is performed. A larger biopsy needle is used to extract a solid part of the bone marrow tissue. The samples are sent to the pathologist for analysis.
After the procedure:
Wound dressing would remain for 24 to 48 hours. In case of local anesthesia, patients can go home soon after the procedure and resume normal activities. Patients who had general anesthesia or intravenous sedation may take a day to fully recover from anesthesia. Patients may experience pain, swelling, and bruising which usually resolve in a week. Pain killers and antibiotics may be prescribed.
What are the complications of bone marrow aspiration and biopsy?
Some common complications encountered are:
- Damage to surrounding nerves and blood vessels
- Bone fracture
Health Solutions From Our Sponsors
Top What Is Bone Marrow Aspiration and Biopsy? Related Articles
Blood Disorders QuizExactly what is sickle cell anemia? Learn about sickle cell and other diseases by testing your IQ with the Blood and Bleeding Disorders Quiz.
Blood Basics Test QuizWhat do you know about blood? It runs all through your body, so educate yourself! Take this blood basics quiz to learn about human blood!
What are the Risks or Complications of a Bone Marrow Procedure?A bone marrow biopsy involves using a large needle to extract a sample from the bone marrow to diagnose blood cancers and other conditions. Bone marrow is often extracted from the pelvic bone. Potential risks of the procedure include pain and soreness and, more rarely, bleeding and infection.
Bone Marrow Transplant Risks and Survival RateThe life expectancy, survival rate and quality of life after a bone marrow transplant have improved considerably with more accurate genetic matching with donors, following up transplantation with an antibiotic regimen to control infections, and improved post-transplant care, in general.
Bone Marrow Transplantation for Breast CancerBone marrow transplantation may be performed after a woman undergoes high-dose chemotherapy for breast cancer. High-dose chemotherapy kills blood cells as well as cancer cells. Bone marrow transplantation involves harvesting stem cells from the bone marrow and infusing them back into the patient to stimulate the growth of new blood cells. The patient must remain isolated until the new bone marrow begins to grow.
Can a Bone Fracture Heal on Its Own?Learn what medical treatments can help your bone fracture heal and help you manage this condition.
What Conditions Do You Need a Bone Marrow Transplant for?Diseases of the marrow and blood can be debilitating or fatal, but for certain diseases, a treatment method is to implant some healthy bone marrow from a genetically compatible donor into a patient in the hope it will grow and replace the diseased marrow. Often, the patient’s own cancerous marrow is destroyed prior to restoring the patient’s marrow with the new healthy donor cells.
Healthy Eating: Foods That Help Increase Blood Flow CirculationGood blood flow circulation occurs when you eat the right foods. Choose cayenne pepper, beets, berries, fatty fish, pomegranate, garlic, walnuts, grapes, turmeric, spinach, and citrus fruit to keep blood flowing.
Hemophilia QuizWhat happens within the body in a person who has hemophilia? Take this quiz to learn about this rare blood disorder.
How Is an Aneurysmal Bone Cyst Treated?Learn what medical treatments can help ease your aneurysmal bone cyst symptoms and help you manage this condition.
How Painful Is Bone Marrow Donor Procedure?This procedure takes place under general anaesthetic, so you won't feel any pain while it's happening.