A bone marrow biopsy is the removal of marrow from inside bone. Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones.
How the Test is Performed
A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used.
Marrow is removed in the following steps:
- If needed, you are given medicine to help you relax.
- The health care provider cleans the skin and injects numbing medicine into the area and surface of the bone.
- A biopsy needle is inserted into the bone. The center of the needle is removed and the hollowed needle is moved deeper into the bone. This captures a tiny sample, or core, of bone marrow within the needle.
- The sample and needle are removed.
- Pressure and then a bandage are applied to the skin.
A bone marrow aspiration may also be done, usually before the biopsy is taken. After the skin is numbed, the needle is inserted into the bone, and a syringe is used to withdraw the liquid bone marrow. If this is done, the needle will be removed and repositioned. Or, another needle may be used for the biopsy.
How to Prepare for the Test
Tell the health care provider:
- If you are allergic to any medications
- What medications you are taking
- If you have bleeding problems
- If you are pregnant
You must sign a consent form.
How the Test will Feel
You will feel a sharp sting when the numbing medicine is injected.The biopsy needle may also cause a brief, usually dull, pain. Since the inside of the bone cannot be numbed, this test may cause some discomfort.
If a bone marrow aspiration is also done, you may feel a brief, sharp pain as the bone marrow liquid is removed.
Why the Test is Performed
Your doctor may order this test if you have abnormal types or numbers of red or white blood cells or platelets on a complete blood count (CBC).
This test is used to diagnose leukemia, infections, some types of anemia, and other blood disorders. It may also be used to help determine if a cancer has spread or responded to treatment.
A normal result means the bone marrow contains the proper number and types of blood-forming (hematopoietic) cells, fat cells, and connective tissues.
What Abnormal Results Mean
Abnormal results may be due to cancers of the bone marrow (leukemia, lymphoma, multiple myeloma, or other cancers).
The results may detect the cause of anemia (too few red blood cells), abnormal white blood cells, or thrombocytopenia (too few platelets).
Additional conditions for which the test may be performed:
- Disseminated coccidioidomycosis (a body-wide fungal infection)
- Hairy cell leukemia
- Hodgkin or non-Hodgkin lymphoma
- Idiopathic aplastic anemia
- Multiple myeloma
- Myelodysplastic syndrome (MDS)
- Polycythemia vera
- Primary amyloid
- Primary myelofibrosis
- Primary thrombocythemia
- Secondary aplastic anemia
- Secondary systemic amyloid
- Waldenstrom macroglobulinemia
There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.
Biopsy - bone marrow
Choby B. Bone marrow aspiration and biopsy. In: Pfenninger JL, Fowler GC, eds. Pfenninger & Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 205.
Hutchison RE, McPherson RA, Schexneider KI. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 30.
Review Date 5/29/2014
Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.