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What is Bone Marrow ?	How do you feel after a Bone Marrow Biopsy ?
What is Bone Marrow Biopsy ?	What are the risks of Bone Marrow Biopsy ?
Why is Bone Marrow Biopsy done ?	FAQs
How is Bone Marrow Biopsy done ?	Glossary
Where is Bone Marrow Biopsy and aspiration taken from

What is Bone Marrow ?

Bone Marrow is the tissue present inside our long bones, which are responsible for producing blood cells. It contains stem cells, the base for producing red blood cells, white blood cells, platelets and other blood components.

What is Bone Marrow Biopsy ?

Bone marrow biopsy is the removal of bone marrow tissue and is often done with a bone marrow aspiration.
Bone marrow aspiration is a procedure of withdrawing fluid or marrow from the inside of the bone through a needle into a syringe.

Why is Bone Marrow Biopsy done ?

A bone marrow aspiration and biopsy procedure is done

To evaluate the bone marrow function.

It may aid in the diagnosis of low numbers of red blood cells (anemia), low numbers of white blood cells (leucopenia), or low numbers of platelets (thrombocytopenia), or a high number of these types of blood cells.

It also can be done to monitor treatment for certain types of blood disorders.

Test is done to diagnose tumors, prognosis of the disease, such as lymphoma, and evaluation of the effectiveness of chemotherapy.

Bone marrow culture and sensitivity test is done to see if a bacterial, viral, or fungal infection is present and to identify antibiotics that might be appropriate for treating the infection.

Bone marrow aspiration is also done to collect bone marrow for stem cell transplantation or chromosomal analysis.

How is Bone Marrow Biopsy done ?

The skin over the biopsy site is cleaned with an antiseptic solution and a local anesthesia is injected to numb the area.
The biopsy needle is inserted through the skin and into the bone to reach the bone marrow. Once inside the bone, the center portion of the needle is removed and a syringe is attached to the end of the needle and the marrow (which is liquid) is withdrawn.
For a bone marrow biopsy, a core of tissue is trapped inside the center needle before it is removed.
Each test takes about 10 to 20 minutes and you have to lie down for 10 to 15 minutes after the procedure.
The samples are prepared and sent to the laboratory for analysis. After collecting the samples pressure is applied to help stop any bleeding and a bandage is applied to the site.

Where is Bone Marrow Biopsy and aspiration taken from ?

A biopsy of a solid form of bone marrow is generally taken from the hipbone.
A bone marrow aspiration is usually taken from the pelvic bone (ileum) which is easily accessible from the Lower back, near the hip.
Bone marrow can also be taken from the front of the pelvic bone (near the groin) or the sternum (the center bone in the chest).
Adults usually have a sample of bone marrow fluid taken from the back of the hip bone (Posterior ileum).
Infants and young children may have samples taken from the front of the lower leg bone, just below the knee.

How do you feel after a Bone Marrow Biopsy ?

You may feel a sharp sting and a burning sensation when the anesthesia is injected to numb the skin over the biopsy site and into the covering of the bone.

You may hear a soft crunching sound and feel pressure and pain when the biopsy needle enters the bone. The pain may be intense, but it usually lasts for a few seconds.
During an aspiration, you may feel a brief, shooting pain down your leg as the marrow fluid is taken. This pain should stop as soon as the sample is taken and the biopsy site is monitored for bleeding.

You may need to stay in bed for 30 to 60 minutes after the procedure so the site can be monitored for bleeding and your bandage can be removed after 1 hour.

If you are given a sedative, avoid driving or other activities that require alertness until you are fully recovered.

You may feel some soreness at the biopsy site for several days and Ice packs are applied to the area, walking, and pain medication can be used to relieve the discomfort. However, the site may feel sore (like a bad bruise) for several days.

The site may bleed a small amount; ask your health professional how much drainage to expect.

What are the risks of Bone Marrow Biopsy ?

Serious complications resulting from a bone marrow aspiration or biopsy are rare.
Risks include :

Excessive bleeding from the biopsy site. This risk is high for people with bleeding problems. If you have bleeding problems, apply pressure to the biopsy site for at least 10 minutes after the procedure.

Infection at the biopsy site (Osteomyelitis).
Call your health professional immediately if you notice :

Increased tenderness, pain, redness, or swelling at the biopsy site.

Fever higher than 100.4 °F (38 °C).

Excessive bleeding or drainage, such as pus, through the bandage. If excessive bleeding occurs, apply pressure to the biopsy site and contact your doctor.

FAQs

Who does a Bone Marrow Biopsy ?
A bone marrow biopsy is usually done by a hematologist, Medical Oncologist, or pathologist, or by a specially trained technologist.

What should your doctor know before a Bone Marrow Biopsy ?
Whether you are allergic to any medication, including anesthetics.
You have any bleeding problems or take blood-thinning medications, such as aspirin or warfarin (Coumadin).
You are or might be pregnant.

What are the factors that affect the Bone Marrow Biopsy Test?

A recent blood transfusion or treatment with medications that contain iron can affect bone marrow biopsy results.

Rough handling, contamination, or inadequate refrigeration of the bone marrow sample can cause inaccurate test results.

Previous radiation treatment to the site where the bone marrow sample is removed may affect test results.

Obtaining a bone marrow sample from the hipbone of an obese person may be difficult. It may be easier to use the front of the hipbone (anterior iliac crest) or the breast bone (sternum).

What are the New Bone Marrow Biopsy Needles and Procedures used to Minimize Pain ?
Recently, specimen capturing bone marrow biopsy needles have been introduced to minimize the pain resulting from manipulations of the bone marrow needle and to help your doctor ensure recovery of adequate specimens.

The SNARECOILTM bone marrow biopsy needle is a specimen capturing needle that incorporates a tiny internal snare mechanism that coils around the tip of the specimen after it has entered the needle and thereby captures it.

This mechanism eliminates the need to significantly move the needle after it has been advanced into the bone marrow tissue to sever and recover the specimen. This advantage is relevant not only for the patient who may require a single bone marrow biopsy for diagnosis but especially for those patients with hematologic malignancies such as leukemias or lymphomas who may require multiple procedures to evaluate the efficacy of their treatments.

Glossary

Red blood cells : Cell specialised for oxygen transport, having a high concentration of haemoglobin in the cytoplasm.
White blood cells : cells which circulate in the blood and lymphatic system and harbor in the lymph glands and spleen. They are part of the immune system responsible for both direct and indirect immune response to fight against foreign invaders of the body.
Platelets : Platelets are found in the bloodstream that binds to fibrinogen at the site of a wound to begin the blood clotting process
Stem cells : Cells that gives rise to a lineage of cells. Particularly used to describe the most primitive cells in the bone marrow from which all the various types of blood cell are derived
Chromosome : The self-replicating genetic structures of cells containing the cellular DNA that bears in its nucleotide sequence the linear array of genes.
Osteomyelitis : Inflammation of bone caused by microorganisms. It may remain localised or may spread

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