Biopsy - bone marrow

Definition    Return to top

Bone marrow is soft tissue found inside some of the larger bones in the
body. The marrow produces platelets and red and white blood cells. A
biopsy is a method of removing a small tissue sample from the body to
have it examined under a microscope and possibly analyzed by other
tests.

How the test is performed    Return to top

The bone marrow biopsy may be done in the health care provider's office
or in a hospital. The sample is usually taken from the hip bone. The
skin is cleansed, and a local anesthetic is injected to numb the skin.

The biopsy needle is then inserted into the bone. The core of the
needle will then be removed, and the needle is pressed forward and
rotated in both directions. This forces a tiny sample of the bone
marrow into the needle. The needle is then removed. Pressure is applied
to the biopsy site to stop bleeding, and a bandage is applied.

An aspirate may also be performed, usually before the biopsy is taken.
After the skin is anesthetized, the aspirate needle is inserted into
the bone, and a syringe is used to withdraw the liquid bone marrow. If
this is performed, the needle will be removed and either repositioned,
or another needle may be used for the biopsy.

How to prepare for the test    Return to top

Inform the health care provider if you have allergies to any
medications, about which medications you are taking, and if you have
bleeding problems. The health care provider should also know if you are
pregnant. You must sign a consent form.

For infants and children:

The preparation you can provide for this test depends on your child's
age and experience. For specific information regarding how you can
prepare your child, see the following:
Infant test or procedure preparation (birth to 1 year)
Toddler test or procedure preparation (1 to 3 years)
Preschooler test or procedure preparation (3 to 6 years)
Schoolage test or procedure preparation (6 to 12 years)
Adolescent test or procedure preparation (12 to 18 years)

How the test will feel    Return to top

There will be a sharp stinging from the anesthetic injection. As the
aspirate is withdrawn, there may be a brief, sharp pain. The biopsy
needle may also produce a brief pain, usually more dull. Since the
interior of the bone cannot be anesthetized, this test may cause some
discomfort. Not all patients experience these symptoms, however.

Why the test is performed    Return to top

The test is done after abnormal types or numbers of red or white blood
cells are found in a complete blood count, or to evaluate whether other
systemic diseases are present in the bone marrow.

The examination may detect the cause of the abnormality, certain types
of anemia (not enough red blood cells), cancer in the marrow, and may
be used to monitor the response to therapy for some cancers.

Normal Values    Return to top

The marrow has normal cells that are the correct types and numbers.

What abnormal results mean    Return to top

The results may indicate cancers of the bone marrow (leukemia or
Hodgkin's disease). The results may detect the cause of anemia (too few
red blood cells), abnormal white blood cells, or thrombocytopenia (too
few platelets).

Additional conditions under which the test may be performed:
Coccidioidomycosis; disseminated
Hairy cell leukemia
Hodgkin's lymphoma
Idiopathic aplastic anemia
Multiple myeloma
Neuroblastoma
Non-Hodgkin's lymphoma
Polycythemia vera
Primary amyloid
Primary myelofibrosis
Primary thrombocythemia
Secondary aplastic anemia
Secondary systemic amyloid

I had this done and it was just uncomfortable.  I did take a couple of Xanax
prior to the procedure. I was quite nervous about it, but it was not nearly
as bad as I thought it would be.
The sample was taken from my hip and I went home with a little band-aid.
Hope this helps.
Joy

Hello David and welcome to alt.support.cancer.
I've never had a bone marrow biopsy but apparently as the aspirate is
withdrawn, there may be a brief, sharp pain. The biopsy needle may also produce
a brief pain, usually more dull. Since the interior of the bone cannot be
anesthetized, this test may cause some discomfort. Not all patients experience
these symptoms, however.

There's more here about various biopsy sites and additional information.
http://my.webmd.com/hw/lab_tests/hw200221.asp
(Some of the reasons for such are also mentioned on this webpage).
There may be other reasons, so perhaps you'd best obtain the information from
your father?

If you tell me the type of leukemia, I might be able to find you a specific
support list.
Of course, you're welcome to stay here as well.
Keep in touch and let us know how it's going.
J

A wide variety of opinons are expressed on the question of pain.  I was
really anxious on my first one, and greatly benefited from my wife being
there holding my hand, etc.  However, in my latter ones, I would just go to
the Dr. office or hospital on my lunch time and then return to work.  For
me, the greatest pain was the lidocain injection, which was not a big deal.  
However for many others, including my father, the pain is considered
extreme - many such people like having some sedative medication before the
procedure.

Having a BMP does not necessary mean anything about the seriousness of the
leukemia.  It is an assessment procedure that some doctors use more
frequently than others.

It's virtually painless if done properly.

You are posting from the toronto area?

my dad had Leukemia and i was there when he had the biopsy. painless if
the doc does it right.

Gail

When I had it done it was no problem at all.  Very little pain.
Apparently it hurts less when people are older as the bone is softer; I
was 62.  The doctor told me that some people feel light-headed as the
sample is being taken out.  I didn't feel that either.  I believe it
was taken from my ilium (to the side of my lower back).
-Harold

Hi, David,

I was diagnosed with non-Hodgkins lymphoma and also had this done.
Along with several other biopsies.  As I understood it, it was to help
my doctor stage the cancer.

Pain was minimal, I was given lidocane (sp) - just a quick pinch and a
sedative.  The actual procedure was over in less than 15 minutes (and
I had 2 samples taken) and by the time my ride showed up, I was
feeling pretty darned good - yay sedatives!  There was a little
soreness at the sites when the drugs wore off, but nothing big.

Good luck to you and your father.
Carla

Hey everyone, thanks for replying with all the helpful information, I really
appreciate it!

Just an update with what happened... the biopsy was scheduled for next
week... but my father had a doctors appointment a couple days ago.. and the
doctor said my father did not need to have the biopsy anymore because his
white blood cells were back up to nearly normal! :)

What had happened was... he had previously gone through two cycles of chemo
for his leukemia, and the doctors noticed his bone marrow took a major hit
reacting with the chemo... so they stopped the chemo and waited for his
white counts to come back up... it took nearly three months to this day, but
this has been the best news since he started treatment.

The doctor said for now we'll wait and let his body naturally produce more
white blood cells, and also observe his general health... and as for chemo,
they said they will change the type so it hopefully won't affect my fathers
bone marrow as much as the other did, as it seems his is very sensitive.

Thank you again for all your help, I will keep everyone informed.

-David