Bone Marrow Biopsy

A bone marrow biopsy is a procedure that takes a small sample of the marrow inside your bones for testing in a laboratory. This test is used to see if you have an infection, disease, or other problem in your bone marrow.

Bone marrow is the spongy tissue found inside your bones. In the larger bones— such as your spine, breastbone, hips, ribs, legs, or skull—bone marrow contains cells that produce white blood cells, red blood cells, and platelets. Your white blood cells help fight infection, your red blood cells carry oxygen and nutrients, and your platelets enable the blood to clot.

Marrow has both solid and liquid parts. If the solid portion of the bone is sampled, this is called a biopsy. Aspiration is the procedure used to collect the liquid part of the marrow.

Problems with bone marrow can create lasting, serious health concerns. A bone marrow biopsy is one of many tests that can be done to check the cells of your bone marrow for problems and may be done at the same time as a bone marrow aspiration.

Why Is a Bone Marrow Biopsy Done?

Numerous conditions are associated with unhealthy bone marrow. If blood tests show low levels of platelets or white or red blood cells, your doctor may order a bone marrow biopsy.

This test also allows your doctor to check for a suspected disease, see how far a disease has progressed, or monitor the effects of a treatment method.

According to the Mayo Clinic, conditions and diseases that can affect your bone marrow include:

  • Anaemia, or a low red blood cell count
  • Bone marrow diseases, such as myelofibrosis or myelodysplastic syndrome
  • Blood cell conditions, such as leukopenia or polycythemia
  • Cancers of the bone marrow or blood, such as leukaemia or lymphomas
  • Hemochromatosis, a genetic disorder in which iron builds in the blood
  • Infection, such as sepsis

A bone marrow biopsy is also an important test if you are undergoing cancer treatment, since it can help determine if the cancer has spread to your bones.

Bone marrow biopsy performed at Odette Cancer Center, Toronto, Ontario March 10 2008

What Happens During a Bone Marrow Biopsy?

A bone marrow biopsy is commonly done using a pelvic bone, but another bone (such as the breastbone) may be used. In a child, a leg bone or vertebra (bone in the spine) may be used.

The doctor will inject a local anesthetic to numb the area.

A small incision may be made over the biopsy site. The biopsy needle will be inserted through the surface of the bone and into the bone marrow. The doctor will remove a small, solid piece of bone marrow using a special hollow needle; this is called a core biopsy.

The biopsy needle will be withdrawn. Firm pressure will be applied to the biopsy site for a few minutes, until the bleeding has stopped, and a sterile bandage or dressing will be applied. The bone marrow samples will be sent to the lab for exam.

Your child may feel some pain when the needle is placed in the bone and may feel pressure or “tugging” when the needle removes a small piece of spongy bone marrow.

Numbing medicines and sometimes sedation can minimise pain and anxiety. Lying still can be stressful for children. Rehearsing the position before the test can help your child to feel in control and understand what he or she needs to do. Helping your child understand what will happen will reduce anxiety.

If your child is awake, distraction or other coping techniques will sometimes assist the child in getting through the procedure.

Tylenol or codeine may be needed for a day or two after the procedure for pain.

Risks of a Bone Marrow Biopsy

All medical procedures carry some type of risk. According to the Mao Clinic, bone marrow exams are safe.

In some rare instances, however, the following complications are possible:

  • allergic reaction to anaesthesia
  • excessive bleeding
  • infection
  • long-lasting discomfort at the spot where the biopsy was taken

These risks are rare and most often occur among people who have other conditions that weaken their immune systems or lower their platelet counts.