Bone Marrow Aspiration and Biopsy

What is bone marrow?

Bone marrow is a spongy material found inside our large bones, such as the femur (thigh), hips, and ribs. It is made up of cells called hematopoietic stem cells. Hematopoietic stem cells are "baby" cells that become either white blood cells, red blood cells, or platelets. Your bone marrow grows and stores these cells until they are needed. Cancer cells can find their way into your bone marrow, making it hard for the marrow to do its job of making healthy blood cells.

What are bone marrow aspiration and biopsy?

Bone marrow aspiration and biopsy are tests used to see how your bone marrow is working, or to check for cancer cells.

• Bone marrow aspiration uses a needle to take a sample of bone marrow fluid from inside the bone. 
• Bone marrow biopsy uses a needle to take a small sample of the bone and marrow.

These samples are then looked at and tested under a microscope. This may be done before treatment as part of diagnosis, or after treatment to check how your body has responded to that treatment.

What can I expect during the procedure?

The procedure is done by a provider in your hospital room or outpatient clinic. Your hip or breastbone area will be used for bone marrow aspiration. Your hip is used for bone marrow biopsy. You will be asked to lie on your stomach or side, so the area can be reached easily. If both an aspiration and biopsy are being done, your provider will likely do both on a hip bone. Your provider will explain the procedure as it is done, but these are the steps so you know what to expect:

• The skin will be cleaned with an antiseptic soap, which might feel cold.
• The area where the sample will be taken will be "numbed" with lidocaine. A small needle is used to give the numbing medicine in the area. The lidocaine may burn but this feeling only lasts a few seconds. 
• After the numbing medicine has had a few minutes to work, a needle will be placed into the bone, and bone marrow fluid will be taken out with a syringe. You may feel a pulling or drawing feeling down your leg while the sample is being taken. This will only last a few seconds.
• If a biopsy is ordered, it is done right before or after the aspiration by placing a needle into the bone and removing a small sample. During this part of the procedure, you may feel the pressure of the needle and a sharp, sucking sensation as the marrow is pulled into the needle.
• In most cases, the entire procedure takes 20 to 30 minutes. A bandage will be placed on the area after the procedure.
• After the numbing medicine wears off, you may feel discomfort at the needle insertion site. Walking may help with this discomfort.

Instructions for after the procedure:

• Keep the bandage clean and dry for 24 hours. After this time, you can take off the bandage and bathe or shower.
• Call your provider if:
  • Bleeding occurs after your bone marrow aspiration or biopsy, put pressure on the area and call your provider.
  • You have pain for more than 24 hours in the area where you had your biopsy or aspiration.
  • You notice redness or drainage at the site or if your temperature is 100.4°F (38.0°C) or higher.
  • You have numbness or weakness in the area where you had the bone marrow or down your leg.

Be sure to ask your provider if you have any other questions about bone marrow aspiration and biopsy.