Bone Marrow Aspiration

Overview

Bone marrow aspiration is a medical procedure aimed at extracting a small amount of bone marrow, the sponge-like tissue within your bones responsible for blood cell production. This process, along with a bone marrow biopsy, is employed to assess the overall health of the bone marrow and determine if it is generating the appropriate quantities of blood cells. These diagnostic techniques are crucial for identifying and monitoring various blood and marrow disorders, including certain types of cancers and unexplained fevers.

Healthcare providers may request a bone marrow aspiration to evaluate the production of red blood cells (RBCs), white blood cells (WBCs), and platelets. During the procedure, a needle is utilized to withdraw a sample of the fluid portion of the bone marrow. In parallel, a bone marrow biopsy involves using a needle to retrieve a sample of the more solid portion.

Although bone marrow aspiration can be conducted independently, it is typically combined with a bone marrow biopsy, collectively referred to as a bone marrow exam. This comprehensive approach provides a more thorough understanding of the bone marrow’s condition and aids in accurate diagnosis and monitoring of various medical conditions.

Reasons for undergoing the procedure

A bone marrow aspiration may be conducted to identify or diagnose conditions related to the bone marrow, especially if blood tests reveal irregular levels of red blood cells (RBCs), white blood cells (WBCs), or platelets. This procedure is often ordered when blood tests are inconclusive or insufficient in providing information about a suspected problem.

Your healthcare provider may perform a bone marrow exam for various reasons, including:

• Diagnosing diseases or conditions affecting the bone marrow or blood cells.
• Determining the stage or progression of a disease.
• Assessing iron levels to ensure adequacy.
• Monitoring the treatment progress of a disease.
• Investigating fevers of unknown origin.

This procedure is applicable to a range of conditions such as anemia, abnormal production of blood cells (leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, pancytopenia, and polycythemia), blood and bone marrow cancers (leukemias, lymphomas, and multiple myeloma), cancers that have metastasized to the bone marrow from other areas, and conditions like hemochromatosis.

In certain cases, your healthcare provider may use a bone marrow aspiration to assess the health of your bone marrow before or after treatments like bone marrow transplants.

Risk

Bone marrow exams are typically safe procedures, with rare complications. These may include:

• Excessive bleeding, especially in individuals with low platelet counts.
• Infection, typically limited to the skin at the examination site, particularly in those with compromised immune systems.
• Persistent discomfort at the bone marrow exam site.
• Infrequent incidents of sternum penetration during sternal aspirations, leading to potential heart or lung complications.

Procedure

A bone marrow sample may be examined by a healthcare provider for:

• Blood cell counts.
• Any sign of cancer cells.
• Signs of infection.

The patient will discuss about treatment options and next actions with the healthcare provider if any indications of a health issue are discovered.

Before the procedure

Bone marrow exams are typically done on an outpatient basis with no specific preparation required. However, if you’re receiving a sedative, your doctor may advise you to refrain from eating and drinking before the procedure. Arrange for someone to drive you home if sedation is involved.

Inform your doctor about any medications or supplements you take, as some may increase bleeding risk. If you’re anxious, discuss your concerns with your doctor, who may provide a sedative and local anesthesia at the needle insertion site.

During the procedure

Your healthcare provider typically extracts a bone marrow sample from your pelvis (hip bone) by inserting a needle near your lower back, close to the hip. Before the procedure, you receive an injection of a numbing medication to ensure a painless experience. Sedation may also be used to keep you relaxed but awake.

During the bone marrow aspiration:

• You lie on your stomach or side on an exam table.
• The technician or doctor inserts a hollow needle into your pelvic bone.
• A syringe is attached to the needle to withdraw a sample of bone marrow liquid.
• The needle and syringe are removed.
• A bandage is placed over the area for infection prevention and to aid healing.

After the procedure

After a bone marrow aspiration, you’ll typically go home on the same day. Depending on the anesthesia type, you might need to wait at your healthcare provider’s office until its effects subside. It’s important to arrange for someone to drive you home following the procedure.

Outcome

Following a bone marrow aspiration, it is crucial to maintain cleanliness and dryness around the bandage for a minimum of 24 hours. Your medical team will provide guidance on when to remove the bandage.

Typically, individuals may experience discomfort near the needle insertion point for several days. Pain during bending or radiating down the back of the leg is common. Additionally, mild bruising on the lower back or buttocks may develop within the initial week post-bone marrow aspiration.

Should you experience a fever or notice any symptoms at the needle insertion site, promptly contact your healthcare provider. Look out for signs such as discharge, excessive bleeding, swelling, or warmth around the area. These may indicate potential complications that require immediate attention.