Bone Marrow Test

What Happens During a Bone Marrow Aspiration or Biopsy

Technician performing bone marrow transplant
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A bone marrow biopsy or aspiration is a procedure to collect a small amount of bone marrow cells or tissue for testing and analysis in the lab by a hematologist. Here are the steps to a bone marrow aspiration or biopsy.

The usual site for the test is the iliac crest, the hip bone, of one of both hips. But sometimes it is taken from the sternum, the breastbone. In infants, it might be taken from the shin bone. 

Where is the Bone Marrow Test Done?

The bone marrow test is usually done as an office procedure. No special preparation is needed before the procedure. You can expect that you'll need to disrobe, as they will be taking a sample from your hip or your breastbone. You will usually only be getting a local anesthetic, so you will be able to drive or take public transportation after the procedure.

It will be performed by your doctor or a nurse specialist, physician's assistant or other trained specialist. They may have a laboratory technologist assisting to collect the sample and make smears immediately during the procedure.

Before the Bone Marrow Test

Your heart rate, blood pressure, and temperature will be taken. If it appears you are having anxiety, you may be given a mild sedative. Be sure to tell your doctor about any allergies, medications or supplements before the test.

What Happens During a Bone Marrow Test?

The marrow sample is usually taken from the hip bone. When taken from the hip bone, you will be asked to lie prone (on your abdomen) or to one side. You'll be draped with sterile cloth so only the aspiration site is exposed. The skin is cleansed with an antiseptic, and a local anesthetic is injected to make the skin numb.

For bone marrow aspiration, a thin needle is inserted into the bone and advanced inwards with a slow rotating movement till the marrow is reached. A small amount of liquid marrow is withdrawn.

For a bone marrow biopsy, a thicker biopsy needle is inserted into the bone. The core of the biopsy needle is removed, and the needle is pressed forward into the marrow and rotated in both directions. A small sample of the bone marrow enters into the needle.

After either procedure, the needle is removed and pressure is applied to the area to stop any bleeding. The area may be covered with a small antiseptic dressing. You'll be asked to keep lying down for 10-15 minutes. You are then free to leave. You should keep the test site dry and covered for two days.

Will the Bone Marrow Test Hurt?

The area will be numbed, but you are likely to feel pulling and pushing pressure and a brief, sharp pain during the procedure. Some people liken it to a pinching sensation. You may have some soreness later when the local numbing medication wears off.

Are There Complications to Worry About?

The bone marrow test only rarely has any complications. Bleeding at the site needs to be reported to your doctor. Signs of infection that should be reported include redness at the site, fever, and pain that is increasing.

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