Patient education: Bone marrow aspiration and biopsy (The Basics)

What is a bone marrow aspiration and biopsy? — These are procedures to remove a small sample of your bone marrow. The sample is sent to a lab where doctors will look at it under a microscope.

Bone marrow is the spongy tissue inside some of your bones. It makes blood cells, which your body needs to work normally. "Aspiration" means taking a sample of the liquid part of bone marrow. "Biopsy" means taking a sample of the solid part. Most of the time, aspiration and biopsy are both done during the same procedure.

Bone marrow aspiration and biopsy can be done for different reasons, including to:

●Learn more if a person has abnormal blood test results

●Check for a condition that affects blood or bone marrow, such as leukemia, lymphoma, or aplastic anemia

●See how treatment is working when a person has a known condition

●Try to figure out why a person has a fever

●Prepare to donate bone marrow to another person

How do I prepare for the procedure? — Before your procedure, your doctor will do an exam and ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

The doctor or nurse will tell you if you need to do anything special to prepare. In some cases, the doctor might prescribe a medicine to help you relax during the procedure.

Before your procedure, your doctor might send you to get lab tests.

What happens during the procedure? — When it is time for the procedure:

●You will lie on an exam table. Most of the time, you will be either face-down or on your side.

●The doctor will feel the area to decide exactly where to take the bone marrow from. This is usually the back of the hip bone (figure 1). In some cases, a different area is used.

●The doctor will give a shot of medicine to numb the area. This also helps relieve pain from the procedure. Sometimes, they might use "light sedation." This means giving medicines to make you relax and feel sleepy.

●The doctor will make a very small cut in your skin. Then, they will put a needle through your skin and into the bone. You will probably feel some discomfort or pain when this happens. They will attach a syringe to the needle to remove some of the liquid part of the bone marrow.

●If they are doing a biopsy, the doctor will use a different needle to remove a solid sample from the bone marrow.

●The samples will be sent to a lab for testing.

●The doctor will remove the needle and cover the area with a clean bandage.

What happens after the procedure? — After the procedure, you will stay lying down for at least 10 to 15 minutes. The doctor or nurse will make sure that the area has stopped bleeding before you get up.

As you recover:

●You will get medicine if needed to help with pain. You can take non-prescription medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol). The doctor might recommend you avoid "NSAID" medicines, which can increase your risk of bleeding. NSAIDs include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve).

●If you had sedation, someone will need to bring you home after the procedure.

●Keep the area dry and covered with a bandage for at least 24 hours after the procedure. Avoid exercise and other heavy physical activity during this time. After 24 hours, you can return to your usual activities as you feel ready.

What are the risks of bone marrow aspiration and biopsy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●The needle breaking

●Severe pain

What else should I know? — Before you go home, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor or nurse's instructions. Ask questions about anything you do not understand.

When should I call the doctor? — Call for advice if:

●The area where the needle went in starts swelling or bleeding again.

●Your pain gets worse.

More on this topic

Patient education: Aplastic anemia (The Basics)
Patient education: Leukemia in adults (The Basics)
Patient education: Leukemia in children (The Basics)
Patient education: Lymphoma (The Basics)
Patient education: Multiple myeloma (The Basics)
Patient education: Acute lymphoblastic leukemia (ALL) (The Basics)
Patient education: Acute myeloid leukemia (AML) (The Basics)
Patient education: Chronic lymphocytic leukemia (CLL) (The Basics)
Patient education: Chronic myeloid leukemia (CML) (The Basics)
Patient education: Autologous bone marrow transplant (The Basics)
Patient education: Diffuse large B cell lymphoma (The Basics)
Patient education: Follicular lymphoma (The Basics)
Patient education: Neutropenia (The Basics)
Patient education: Donating bone marrow or blood stem cells (The Basics)

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Patient education: Chronic lymphocytic leukemia (CLL) in adults (Beyond the Basics)
Patient education: Chronic myeloid leukemia (CML) in adults (Beyond the Basics)
Patient education: Hodgkin lymphoma in adults (Beyond the Basics)
Patient education: Diffuse large B cell lymphoma in adults (Beyond the Basics)
Patient education: Follicular lymphoma in adults (Beyond the Basics)