What is a bone marrow biopsy?

A bone marrow biopsy is a diagnostic procedure that is used to check for blood cell and marrow abnormalities. During a bone marrow biopsy, your doctor will extract red marrow from the back of a hip bone or chest bone.

What is bone marrow?

Bone marrow is the tissue inside your bones where blood vessels and stem cells live. Bone marrow helps produce red blood cells, white blood cells, platelets, fat, cartilage and bone.

What are the types of bone marrow?

There are two types of bone marrow:

  • Red — red marrow is found in your body’s flat bones such as vertebrae and the hip
  • Yellow — marrow becomes yellow as you age as your number of fat cells increases

Why is a bone marrow biopsy performed?

If a blood test shows you have abnormally high or low level of platelets or white or red blood cells, you may need a bone marrow biopsy.

A bone marrow biopsy can be used to:

  • Determine if you have a medical condition involving the bone marrow or red/white blood cells
  • Understand how advanced your condition is
  • Evaluate iron levels
  • Monitor disease progression

Conditions a bone marrow biopsy may be able to diagnose include:

  • Anemia - low red blood cell count
  • Myelofibrosis
  • Myelodysplastic syndrome
  • Leukopenia
  • Thrombocytopenia
  • Polycythemia
  • Leukemia
  • Lymphomas
  • Hemochromatosis
  • Infections of unknown origin

A bone marrow biopsy is typically performed together with a bone marrow aspiration. A bone marrow aspiration is a diagnostic procedure where fluid is extracted from bone.

What are the risks of a bone marrow biopsy?

Although a bone marrow biopsy is a relatively safe procedure, some people experience side effects such as:

  • Hemorrhage — most common side effect of a bone marrow biopsy
  • Excessive bleeding — more common in people with low platelet numbers
  • Allergic reaction to anesthesia
  • Infection — more common in people with weakened immune systems
  • Persistent pain at biopsy site

What to expect during a bone marrow biopsy

A bone marrow biopsy is typically performed in a doctor’s office or hospital by a hematologist or oncologist. The exam takes approximately 10 minutes, and the total procedure takes 30 minutes.

In preparation for the procedure, your care team will apply a local anesthetic to the skin and bone to numb the incision area. Your doctor will make an incision and guide a hollow needle into the hip or the chest bone to collect a sample of red marrow. Some patients experience dull pain during the extraction process. After the procedure, your doctor will stop any bleeding with pressure to the affected area. If there are no complications, you can leave the office within 30 minutes.

Recovery from bone marrow biopsy

You may feel pain at the affected area for a week after the bone marrow biopsy. Call your doctor right away if you experience excessive bleeding, increased pain, swelling, drainage from site or high fever.

Results from a bone marrow biopsy

A pathologist will perform tests on the sample to determine the cause of any bone marrow or blood abnormalities. If you are diagnosed with a cancer such as lymphoma, a bone marrow biopsy can help determine the stage of the cancer.

It will take approximately one to three weeks for results to be ready. Your doctor will schedule a clinic appointment to discuss the results and if necessary, more tests.

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