Bone Marrow Biopsy

What is a bone marrow biopsy and why is it performed?

A bone marrow biopsy involves the removal of a small amount of bone marrow and bone to assist in the diagnosis of blood diseases. The living components of the blood (including red blood cells, white blood cells and platelets) are made in the bone marrow. Looking directly at the bone marrow under the microscope can assist in diagnosis. Other tests, such as evaluating the chromosomes for mutations in the DNA that cause bone marrow cancers are also performed. Often a bone marrow biopsy is the easiest way to exclude a serious bone marrow problem or, if there is a more serious problem, to obtain the correct diagnosis so treatment can be given effectively.

The biopsy procedure itself lasts only a few minutes; however, it can take up to 30 minutes for the whole procedure, including preparing you for sedation, getting you in the right position for the biopsy, doing the procedure itself and ensuring the samples collected are suitable for the diagnosis to be made.

How is the procedure performed?

When you have a bone marrow biopsy, a small amount of liquid bone marrow (the “aspirate”) and solid bone (the “trephine”) are removed from the marrow cavity of the pelvis bone using a needle. A small incision is made in the skin (1-2 mm in length) about 10 cm away from the mid-line of the back before the needle is inserted through to the surface of the bone and then into the bone substance. Only a very small bone fragment is removed (1-2 cm in length, but less than 1mm in diameter) and the bone quickly heals after the procedure. Prior to the procedure, you will generally be asked to roll onto your left side with your knees pulled up as far to your chest as you can. This helps move the back of the pelvis bone near to the skin surface and makes the procedure easier and safer. After you are in this position, the anaesthetist will sedate you. Even though you are asleep and will have pain killing medications administered intravenously, you will also be injected with a local anaesthetic to ensure the area is numb.

All bone marrow biopsies performed by the Brisbane Clinic for Lymphoma, Myeloma and Leukaemia are undertaken as a day procedure at Greenslopes Private Hospital. Bone marrow biopsies are performed with the assistance of a specialist anaesthetist, who will ensure you are asleep and pain free throughout the procedure.

What do you need to do before and after the biopsy?

To ensure that the sedation is safe, you must not eat or drink anything for at least 6 hours before the procedure. If this is not the case, you should tell both Dr Nicol and the anaesthetist. An alternative time can be arranged if necessary. Detailed information about preparing for the biopsy (for example what to wear and how to check in), admission procedures, a description of the possible complications, and what you should do after the biopsy are outlined in the detailed information sheet that you will be given to read before you consent for the biopsy.

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