Explanation

A bone marrow biopsy is a sample of the marrow from inside your bone. The doctor takes out a 1 to 2 cm long piece of bone marrow to see your bone marrow structure. An aspiration is a sample of bone marrow fluid. It gives the doctor some of your bone marrow cells to test.

Bone marrow samples are the best way for doctors to tell if you have a problem with your blood, because the bone marrow is where these problems start. They can also be used to see if you have cancers, like leukaemia and lymphoma.

You may have both of these tests done at the same time - the doctor will take an aspiration first and then take a bone marrow biopsy. You might just have an aspiration though.

Bone marrow samples are usually taken from your hip bone, but aspirations can also be taken from other large bones, like your sternum, lower leg bone or backbone.

Why do I need one?

If you have a high or a low number of platelets, red blood cells, or white blood cells, bone marrow samples can tell your doctor the reason why. So, you will have a sample taken if your doctor thinks you have anaemia or leukaemia, for example.

If you are having leukaemia treatment, bone marrow samples can be used to show your doctor how well your medicine is fighting the illness.

Do I need to do anything before I have it?

You will probably get instructions about not eating or drinking beforehand. At this time, make sure you tell your doctor about any medicines that you are taking, and also tell him or her if you have ever had an allergic reaction to local anaesthetic.

You might need to have a blood test to see how well your blood will clot. This is to check that you are not likely to bleed very much from the place that the sample will be taken from.

What happens?

You will have it done in hospital, probably in outpatients as it's all over in less than 20 minutes! Your doctor might give you some medicine to help you relax and feel a bit sleepy, and will ask you to lie down on your stomach or side. After your skin has been cleaned, you will have an injection of local anaesthetic at the place where the sample is to be taken from. This area will soon become numb.

To do the aspiration, the doctor will suck up a small amount of bone marrow into a syringe. To do the bone marrow biopsy, the doctor will put a needle into the same place and take a small sample of bone and marrow up into the needle.

Are there any risks?

It is rare to have problems, but they do happen occasionally. The two main things that could happen are bleeding or infections at the place where the sample was taken from.

If you have low numbers of platelets in your blood, you are more likely to have bleeding, but it's usually very slight and soon stops. If the bleeding is more serious, you might need a blood transfusion, but this is rare.

Symptoms of infection are redness, soreness and hotness of your skin, so if you notice any of these, contact your doctor or hospital as soon as you can.

Will it hurt?

The local anaesthetic will stop you having a lot of pain. During the aspiration, you might have a short, sharp pain in your bone when the doctor starts to suck the bone marrow cells out. When you have the biopsy, you may have some dull pain in your bone for a short while when the needle is pushed into your bone marrow.

What happens next?

You will have a bandage put on, which you should leave on for a couple of days. You will then probably have to lie down for about half an hour to help stop any bleeding, but you should be able to go home soon afterwards. If the doctor gave you some medicine to help you relax, you will probably feel very tired for a few hours though.

When the local anaesthetic wears off, you might have some pain and bruises for a few days in the area the sample was taken from, but your doctor will give you some medicine to take to help with this. It's important to go and see your doctor if you get spreading redness round the area, if you keep on bleeding and if you have a fever, or if there is anything else you are worried about!

Your bone marrow sample will be sent to a laboratory to be looked at more closely. You will usually get the results within a couple of weeks and your doctor will tell you what will happen next.

What if I have any more questions?

If you have any other questions, you can ask your doctor, or chat to other people about bone marrow biopsy and aspiration in the Medikidz forums and virtual world, Mediland.