Bone Marrow Aspirate and Biopsy
Explanation | Procedure
What is a bone marrow aspirate and biopsy?
Bone marrow is the spongy material found in the center of many bones in the body. The bone marrow is the substance that makes the different types of blood cells.
A bone marrow aspirate and biopsy is done to see if the blood cells in your child's body are being properly made. Aspiration refers to the removal of fluid by suction. A biopsy is the removal of small piece of marrow tissue by a special biopsy needle. Most of the time, this procedure is done under general anesthesia either in the clinic or in the operating room. Sometimes the procedure is done in the clinic under heavy sedation called conscious sedation. It is not unusual for your child to be anxious about this test. Holding your child's hand, talking about something of interest to your child and helping your child pay attention to his breathing may help to relieve anxiety. You may want to ask about a brief general anesthesia for your child versus the conscious sedation approach.
Procedure
Getting ready for the test if done under conscious sedation
Your child will lie on his stomach on a table. A towel may be placed under your child's hips to raise them up. Someone will be there to help your child hold still. The doctor or nurse practitioner doing the test will choose a place, usually on the hip bone, to withdraw the piece of bone marrow. The bone marrow site will be cleaned with a special soap. This may feel cool. After the skin is well washed, sterile towels will be placed around the clean area where the bone marrow test will be performed. The parent(s) may be invited to be present during the test.
The bone marrow aspirate
A small amount of numbing medicine is injected into your child's skin so the test will not hurt as much. This may sting a little bit at first. It takes 1 – 2 minutes for the area to become numb.
After your child's skin is numb, a needle is placed into the bone marrow and a small amount of marrow is pulled up into a syringe. During this part of the test, your child may feel pressure or pain for an instant. Then the needle is withdrawn and this part of the test is over. Bone marrow looks like blood in the syringe.
The bone marrow biopsy is done after the bone marrow aspiration. A new larger needle is in the same place and it is pushed down until a small piece of bone is in the needle. During this part of the test, your child will feel pressure from the pushing. Once the biopsy specimen is in the needle, the doctor or nurse will remove the needle. Sometimes the doctor may decide he needs another piece of the bone for the biopsy. There are several reasons why this might happen. The doctor or nurse practitioner doing the test will explain if this happens to your child.
After the test
The soap will be gently washed off your child's skin. Pressure is applied to the site for 1-2 minutes after the test. A tight fitting bandage is then put over the area where the test was done. The bandage should stay on for 24 hours and then it should be taken off. The bone marrow sample will be studied under a microscope. Your child's doctor will have some of the test results for you within several hours. The biopsy results will take a couple of days to be complete. If you have questions, call your child's doctor.
Bone Marrow Biopsy While Under Brief General Anesthesia
You may discuss with your child's physician the possibility of having the procedure done under brief general anesthesia in the operating room. Only specific times and days are available. The procedure is done by one of the attending staff of the Division of Hematology / Oncology, not necessarily your child's doctor. Recovery is quick and since it's done under general anesthesia, there may only be mild pain following the procedure.
Rev. 3/07
