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Bone Marrow Biopsy by Editorial Staff And Contributors

Definition | Reasons for Procedure | What to Expect | Call Your Doctor

Definition

A bone marrow biopsy is the removal of a sample of bone marrow. The sample is sent for testing. The procedure is most often done on the pelvic bone, but it may also be done on the sternum.

Bone Marrow Biopsy

Reasons for Procedure

A bone marrow biopsy may be done to:

Evaluate unexplained low red blood cell count (anemia), low white cell count (leucopenia), or low platelet count (thrombocytopenia)
Diagnosis and staging of lymphoma (tumors of the lymphoid tissues) or solid tumors
Diagnosis, monitoring and evaluation of leukemias
Evaluate iron level problems
Investigate unexplained spleen enlargement (splenomegaly)
Evaluate other blood disorders

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have this procedure, your doctor will review a list of possible complications which may include:

Infection
Bleeding

Some risk factors for complications during this procedure include:

Bleeding disorders
Infection of the skin at the biopsy site
Infection in the bloodstream
Previous radiation treatment to the biopsy site
Severe osteoporosis

What to Expect

Prior to Procedure

Your doctor may perform a physical exam and blood tests.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

Aspirin or other anti-inflammatory drugs
Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

Local anesthesia will be used. It will numb the area.

Description of Procedure

You may be given a light sedative. It will help you relax. The biopsy area will be cleaned and numbed.

A hollow biopsy needle will be inserted into the bone. The needle will be twisted and advanced. This motion will allow a sample of bone marrow to enter the core of the needle. The doctor may need to use a fair amount of pressure and may need to rock the needle. The needle will then be removed. The bone marrow sample will be inside the needle. Pressure will be applied over the puncture area. A bandage will be applied.

Immediately After Procedure

The bone marrow specimen will be examined by a pathologist. Ask your doctor when to expect the results.

How Long Will It Take?

About 30 minutes

Will It Hurt?

The injection of anesthesia may sting or burn. You may notice a sensation of pressure and/or pain when the biopsy needle is rocked. Once the biopsy is done, you may feel soreness in the area for a few hours.

Post-procedure Care

At Home

You should be able to resume your normal activities after your biopsy. If you have had a sedative, avoid driving or operating equipment until the effects of the medicine have worn off.

Be sure to follow all of your doctor's instructions.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the biopsy site
Nausea and/or vomiting
Cough, shortness of breath, or chest pain
Joint pain, fatigue, stiffness, rash, or other new symptoms

In case of an emergency, call 911.

RESOURCES:

The Leukemia and Lymphoma Society http://www.leukemia.org/hm_lls
National Cancer Institute, National Institutes of Health http://www.cancer.gov/

CANADIAN RESOURCES:

BC Cancer Agency http://www.bccancer.bc.ca/default.htm/
Cancer Centre of Southeastern Ontario http://www.krcc.on.ca/default.asp/

References:

Bone marrow biopsy. National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003934.htm. Updated July 11, 2008. Accessed July 10, 2009.
Pfenninger JL, Fowler GC. Procedures for Primary Care Physicians. St. Louis, MO: Mosby-Year Book; 1994.
Wintrobe MM, Lee GR. Wintrobe's Clinical Hematology. 10th ed. Baltimore, MD: Lippincott, Williams & Wilkins; 1999.

Last reviewed October 2009 by Marcin Chwistek, MD

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