Yesterday, I underwent my 30th bone marrow aspiration and biopsy. I always get both. Well, 29 out of 30 times I’ve had both. Only once did I have just an aspiration. I have wondered all this time why some patients only get the aspiration while others get the aspiration AND the more in depth biopsy. So while I was waiting yesterday, I decided to do some research. So hang on. This one might get deep!
According to www.mayoclinic.org, “A bone marrow biopsy (BMB) and a bone marrow aspiration (BMA) offer different, but complimentary, information about your bone marrow cells. The two procedures are usually performed together.”
Aspirations are a sampling of the liquid portion of the marrow and are primarily utilized for cytologic assessment, cell count, cytogenetics, molecular studies, microbiologic cultures, immunochemistry and flow cytometry. The doctor/technician makes a small incision and inserts a hollow needle through the bone into the marrow. There is brief sharp pain or stinging. Several samples may be taken. The aspirate is the sample of choice for studying and classifying the nucleated blood cells of the bone marrow (eg. ratio of white to red blood cells).
Biopsies, on the other hand, allow evaluation of the marrow’s overall cellularity, detection of focal lesions, and determination of the extent of infiltration by various pathologic entities…by removing a small piece of intact solid bone marrow tissue (0.75 x 0.06 in or 2 x 0.16 cm). The bone marrow is where blood cells are made. The doctor/technician uses a larger needle to withdraw a sample of solid bone marrow tissue. The biopsy needle is specifically designed to collect a core (cylindrical) of bone marrow. There is an strong aching, tugging sensation. The biopsy of bone marrow shows the intact tissue, so that the structure of the fat cells, lymphocytes, plasma cells, fibrous connective tissue cells, and their relationships to each other, can be seen.
Most people are only given a local anesthetic to numb the site and reduce the pain. It is still a procedure, much like childbirth, where slow deep breathing proves very beneficial. For a small percentage, complete sedation may be required. In either case, the BMB or BMA is usually performed in the hipbone (posterior iliac crest). Notes are kept as to which side, right or left, was used and the alternate side will be utilized during the next exam. Scar tissue can build up which increases difficulty and pain during the procedure.
Pressure is applied to stop the bleeding and secure bandaging is required to be left on and dry for forty-eight hours. Test results usually take up to two weeks.
Now, for the reason why some get one and others get both…. Patients with Myelomas, CLL, and Lymphomas need to have BOTH the BMA and the BMB. Patients with other cancers and issues can get their answers met with just the BMA.
I don’t know about you, but I have been wondering about that for quite a while. And now we know…and knowing’s half the battle!
You’re welcome! ☺
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