Bone Marrow Aspiration and Biopsy

  • Reference Number: HEY-492/2018
  • Departments: Haematology, Oncology (Cancer Services)

Introduction

This leaflet has been produced to give you general information about bone marrow biopsy.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a bone marrow aspiration and biopsy?

 A small sample of bone marrow is taken from the back of your hipbone (pelvis). Aspiration means taking a sample of the liquid part of the bone marrow and a biopsy means to take a core of the bone marrow in one piece. The bone marrow biopsy shows the structure of the bone marrow inside the bone, and the aspiration takes just the bone marrow cells.

Why do I need a bone marrow biopsy?

Bone marrow is the substance inside your bones that forms your blood cells.  You need a sample (aspiration/biopsy) of bone marrow taken in order to assist your doctor to diagnose what might be wrong, monitor your condition or assess your response to treatment.

Can there be any complications or risks?

A bone marrow biopsy is a very safe test with few risks. You may experience be some bleeding, however this usually stops rather quickly.  You also may notice some bruising around the biopsy site; this is normal and will fade.

Very rarely there may be more severe bleeding, persistent pain or infection at the biopsy site. Your doctor will discuss any potential complications with you prior to the procedure.

How do I prepare for the bone marrow test?

You do not need to do anything special to prepare for the test. You may eat and drink as normal.

If you are taking medication to thin your blood please let the doctor or nurse know before the biopsy, so they can advise whether you need to stop taking the medication before the procedure.

As with any test you may feel anxious, you are more than welcome to bring someone with you, though usually they will wait outside of the room while the test is being performed.

The doctor will also explain the procedure and you are more than welcome to ask any questions at this point. You will then be asked to complete a consent form (if you have not done this already) to confirm that you are happy to undergo the procedure.

What will happen?

Most of the tests take place in one of the clinic rooms in the Outpatients Department, so you would book in at the reception as you normally would. Firstly you will have a blood test taken and then a bone marrow biopsy.  There may be occasions when these tests are performed on a ward; however the procedure is the same.

The bone marrow is usually taken from the back of the pelvis near the hip bone. You will be asked to lie on a couch/bed on your side and will be covered with a blanket.  It is not usually necessary to undress as long as your hip is accessible.

Your skin will be cleaned with an antiseptic solution and local anaesthetic will be injected into the area where the samples are to be taken, this will numb the area. A needle is then passed through your skin into the bone and the liquid part of the bone marrow is removed by suction (aspirated), a tiny sample of bone marrow (biopsy) is also taken.

You may experience some discomfort during the test, however this usually only lasts for a short period of time. Occasionally some patients may feel a sharp pain when the liquid bone marrow (aspirate) is removed.

Entonox (breathable pain relief) is available to you, which can be used during the procedure should you require it. You may drive home 30 minutes after being administered Entonox, providing you feel well enough to do so.

It is a quick and relatively simple procedure which takes about 10 – 15 minutes to do. You will be offered a drink and be asked to stay within the department / ward for approximately 20 minutes after the procedure.  This is to allow us to check the biopsy site for any bleeding.  After the test, the area where the sample was taken will ache for a few days.  Mild over the counter pain relief medication can be safely taken to make you feel more comfortable (aspirin and ibuprofen should be avoided).  The dressing should be kept dry and left in place for 24 hours after the procedure.

If mild bleeding occurs apply pressure, to the area, for a few minutes. Should you experience a raised temperature, severe bleeding or persistent pain you should contact the department as soon as possible or attend the Emergency Department.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact Oncology/Haematology Department Queen’s Centre  on (01482) 461100

When will I get my results?

The specimens will be sent to the most appropriate laboratory to carry out the test required, but generally your results will be ready one to two weeks after the procedure. You should have been given an appointment to receive the results, if not please discuss this before you leave the department.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.