Bone marrow biopsy and aspiration: what to expect

Who is it for?

Your doctor may ask for this test in the following situations:

• When a complete blood count (CBC) shows an abnormal number or type of red blood cells, white blood cells or platelets
• To find the cause of some types of low blood count (anemia)
• To diagnose some infections
• When a blood cancer such as leukemia, lymphoma or myeloma, or another blood disease, is suspected
• To see whether a known cancer has spread to the bone marrow
• To monitor a known disease and see how well treatment is working

Being asked to have this test does not mean you have cancer. The test is most often done to look for the cause of an abnormal blood result. You can ask your doctor why it is being requested and what the result will change.

How does it work?

Before the procedure, tell your team:

• Whether you take a blood thinner; the team decides whether you need to stop it and when to restart it, so do not stop it on your own
• Whether you have an allergy to any medicine or to local anesthetics
• Whether you have had bleeding or clotting problems before
• Whether you are pregnant, and all the medicines you take

Whether you need to come without eating depends on the center. Most of the time you can eat and drink. If you will be given a sedative, you may be asked to stop eating and drinking a few hours before. Follow the instructions you are given. Before the procedure, you are given information and asked for your consent.

The procedure is most often done in a day unit or on a ward, and you are usually awake. Most often you lie on your side and pull your knees up toward your belly. The biopsy piece is usually taken from the back of the hip bone; the liquid sample can sometimes also be taken from the breastbone. The skin is cleaned with an antiseptic; this may feel cold. Then the numbing injection is given; you may feel a brief sting and burning. Because the inside of the bone cannot be fully numbed, there may be some discomfort. You will feel pressure as the needle goes into the bone. When the liquid marrow is drawn out, there may be a sharp pain or a pulling feeling that lasts a few seconds. When the biopsy piece is taken, you mostly feel pressure.

The experience varies from person to person. Some centers may offer a sedative tablet or a pain-relieving gas that you breathe in. If your pain becomes much worse, tell the team right away.

Taking the sample takes a few minutes. The whole procedure usually takes about 20–30 minutes. With preparation and a short rest, you may be asked to set aside about an hour at the hospital.

Afterwards

Pressure is applied to the place where the needle went in for a while, and a sterile dressing is put on it. If you feel well, you can usually go home the same day.

General advice for the following days is below. Your own team's instructions always come first.

• Usually keep the dressing in place for 24 hours; some centers ask you to leave it for 2–3 days
• Keep the area dry; one NHS hospital's leaflet advises showering after 24 hours and avoiding baths and swimming for 48 hours
• If there is a small amount of bleeding, press on it and change the dressing
• You may have pain, tenderness, bruising or tingling in your hip or leg that lasts a few days
• Mild pain relievers may help; ask your team which one you can use

If you were given a sedative, someone needs to take you home and stay with you overnight. For the first 24 hours, do not drive, drink alcohol or operate machinery.

Results are not ready on the day of the procedure. Some basic results may be ready within 1–2 days. Full results often take 1–2 weeks, and some special tests may take several weeks. Results are usually discussed with you at a follow-up appointment.

In Türkiye

In Türkiye, under the Patient Rights Regulation, your consent is obtained before a medical procedure. You are told who will do the procedure, where, how and roughly how long it will take, the possible complications and the other options. If the hospital uses a consent form, the form is signed in two copies and one copy is given to you. You also have the right to refuse the procedure; in that case, the possible consequences are explained to you. You can review your health records, including the results report, and get a copy.

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