Bone Marrow Biopsy
What is a bone marrow biopsy?
A bone marrow biopsy involves removing a small sample of the bone marrow inside your
bones for testing. Bone marrow is a soft tissue in the center of most large bones.
It makes most of the body's blood cells.
The biopsy is done using a small needle inserted into the bone. The bone marrow tissue
is removed and then sent to a lab and checked under a microscope. You may be given
a shot (injection) of a local anesthetic before the biopsy. This will numb the area
so you don’t feel any pain.
Why might I need a bone marrow biopsy?
A bone marrow biopsy is usually done if your healthcare provider thinks that you have
a problem making blood cells. A specialist called a pathologist examines blood and
bone marrow samples in a lab. The pathologist can check your bone marrow for any of
- Unexplained anemia (lack of red blood cells)
- Abnormal numbers of blood cells (red blood cells, white blood cells, or platelets)
- Lack of iron (iron deficiency)
- Cancers of the blood-forming tissue (leukemia or lymphoma)
- Cancers that have spread to the bone marrow
- Response to chemotherapy
There may be other reasons for your healthcare provider to recommend a bone marrow
What are the risks of a bone marrow biopsy?
As with any procedure, problems can occur. Some possible complications may include:
- Bruising and discomfort at the biopsy site
- Prolonged bleeding from the biopsy site
- Infection near the biopsy site
You may have other risks that are unique to you. Be sure to discuss any concerns with
your healthcare provider before the procedure.
How do I get ready for a bone marrow biopsy?
- Your healthcare provider will explain the procedure to you. Ask him or her any questions
- You may be asked to sign a consent form that gives permission for the procedure. Read
the form carefully and ask questions if anything is not clear.
- Tell your provider if you are pregnant or think you may be pregnant.
- Tell your provider if you are sensitive to or are allergic to any medicines, latex,
tape, and anesthesia medicines (local and general).
- Tell your provider about all the medicines you take. This includes both over-the-counter
and prescription medicines. It also includes vitamins, herbs, and other supplements.
- Tell your provider if you have a history of bleeding disorders. Let your provider
know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other
medicines that affect blood clotting. You may need to stop taking these medicines
before the procedure.
- You may be asked not to eat for several hours before to the procedure. This often
means no food or drink after midnight.
- You may receive a medicine (a sedative) to help you relax before the biopsy. The sedative
may make you drowsy. So you will need to have someone drive you home.
Your healthcare provider may have other instructions for you based on your medical
What happens during a bone marrow biopsy?
A bone marrow biopsy may be done on an outpatient basis. This means you go home the
same day. Or you may stay in a hospital. Procedures may vary depending on your condition
and your provider’s practices.
A bone marrow biopsy is often done using a pelvic bone, but another bone (such as
the breastbone) may be used. In a child, a leg bone or a bone in the spine (vertebra)
may be used.
Generally, a bone marrow biopsy follows this process:
- You will be asked to remove clothing and may be given a gown to wear.
- Your position may vary depending on the bone that is used. You may be asked to lie
on your side or your stomach if the pelvis bone is used.
- During the procedure, you will need to lie as still as possible.
- The skin over the biopsy site will be cleaned with a sterile (antiseptic) solution.
- You will feel a needle stick and a brief sting as the provider injects a local anesthetic
to numb the area.
- A small cut (incision) may be made over the biopsy site. The biopsy needle will be
inserted through the bone and into the bone marrow.
- A bone marrow aspiration is usually done first. The provider will use a syringe to
pull a small liquid sample of the bone marrow cells through the needle. It is common
to feel pressure as the needle is pressed into your bone. You will have a pulling
feeling when the marrow is removed.
- The provider will remove a small, solid piece of bone marrow using a special hollow
needle. This is called a core biopsy.
- The biopsy needle will be removed. Firm pressure will be applied to the biopsy site
for a few minutes, until the bleeding has stopped.
- A sterile bandage or dressing will be applied.
- The bone marrow samples will be sent to the lab for exam.
What happens after a bone marrow biopsy?
Once you are home, it is important to keep the biopsy area clean and dry. Your healthcare
provider will give you specific bathing instructions. Leave the bandage in place for
as long as directed by your provider. This is often until the next day.
Take a pain reliever as recommended by your provider. Aspirin or other pain medicines
may raise your risk of bleeding. Be sure to take only medicines your healthcare provider
Call your provider if you have any of the following:
- Redness, swelling, bleeding, or other drainage from the biopsy site
- More pain around the biopsy site
You may go back to your usual diet and activities unless your healthcare provider
advises you differently.
Your healthcare provider may give you other instructions, depending on your situation.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure