Bone Marrow Aspiration

Bone marrow is the spongy tissue in the center of most large bones of the body. It is a highly vascular structure that produces most of the body’s blood cells.

A bone marrow aspiration is a procedure to collect the liquid portion of the bone marrow. The bone marrow is usually aspirated from the back of the hip bone, but it can also be obtained from the breastbone.

Indications 

Bone marrow aspiration may be ordered by your doctor to:

• Diagnose cancers that affect the bone marrow such as leukemia, lymphoma, and multiple myeloma
• Diagnose cancers that spread to the bone from other parts of the body

• Determine the severity or stage of progression of a disease
• Diagnose blood cell conditions such as anemia, leukopenia, leukocytosis, thrombocytosis, thrombopenia, pancytopenia, and polycythemia.
• Check iron levels in the body
• Investigate possible infection or fever of unknown origin
• Monitor response to treatment

Preparing for Bone Marrow Aspiration

Bone marrow aspiration is a simple procedure that can be performed in an outpatient setting. No special preparation is required other than the following:

• Inform your doctor about your medical history, allergies and medications as some medications may increase the risk for bleeding after the procedure.
• If sedation is provided, you may have to stop eating or drinking a few hours before the procedure.
• Arrange for someone to drive you home after the procedure.

Bone Marrow Aspiration Procedure

The bone marrow aspiration procedure involves the following steps:

• The procedure is usually done while lying on your side.
• A sedative may be given prior to the procedure to help you relax.
• The area of needle insertion is marked and cleaned with antiseptic.
• A local anesthetic is injected to numb the aspiration site.
• A needle is inserted through the skin and into the bone marrow.
• A syringe is then used to draw out the liquid bone marrow. You may experience a temporary sharp pain and then a pulling sensation as this is done.
• After aspiration is complete, a gauze will be used to apply pressure to the needle insertion site to stop any bleeding and a bandage is placed.
• The entire procedure usually takes 20-40 minutes.

Post-procedure Care

You will remain in the recovery room for about 30 minutes after the procedure to ensure there are no adverse side effects. If sedation was provided to help you relax, you may have to wait until the effects wear off before you can go home. Avoid heavy activities for 24 hours after the procedure. You may experience pain at the aspiration site for a few days after the procedure for which medications may be recommended. You can return to routine activities as soon as you feel the pain or discomfort is well controlled.

Risks and Complications 

Bone marrow aspiration is a safe procedure with minimal risks and complications that may include:

• Excessive bleeding
• Infection
• Lasting pain at the needle insertion site
• Allergic reaction to anesthesia

Summary

Bone marrow aspiration is a simple procedure that can be performed in an outpatient setting. It is used primarily to diagnose blood-related diseases and to determine if your bone marrow is functioning properly. The sample of bone marrow will be tested by a pathologist to help establish a diagnosis and select the most appropriate treatment.