Bone marrow aspiration

  • Definition
    • Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination.

      Bone marrow aspiration is not the same as bone marrow biopsy. A biopsy removes actual marrow for examination.

  • Alternative Names
    • Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  • How the Test is Performed
    • Bone marrow aspiration may be done in the health care provider's office or in a hospital. The bone marrow is removed from your pelvic or breast bone. Sometimes, another bone is selected.

      Marrow is removed in the following steps:

      • If needed, you are given medicine to help you relax.
      • The provider cleans the skin and injects numbing medicine into the area and surface of the bone.
      • A special needle is inserted into the bone. The needle has a tube attached to it, which creates suction. A small sample of bone marrow fluid flows into the tube.
      • The needle is removed.
      • Pressure and then a bandage are applied to the skin.

      The bone marrow fluid is sent to a laboratory and examined under a microscope.

  • How to Prepare for the Test
    • Tell the provider:

      • If you are allergic to any medicines
      • If you are pregnant
      • If you have bleeding problems
      • What medicines you are taking
  • How the Test will Feel
    • You will feel a sting and slight burning sensation when the numbing medicine is applied. You may feel pressure as the needle is inserted into the bone, and a sharp and usually painful sucking sensation as the marrow is removed. This feeling lasts for only a few seconds.

  • 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.

      This test is used to diagnose:

      • Anemia (some types)
      • Infections
      • Leukemia
      • Other blood cancers and disorders

      It may help determine whether cancers have spread or responded to treatment.

  • Normal Results
    • The bone marrow should contain the proper number and types of:

      • Blood-forming cells
      • Connective tissues
      • Fat cells
  • What Abnormal Results Mean
  • Risks
    • There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.

  • References
    • Chernecky CC, Berger BJ. Bone marrow aspiration analysis – specimen (biopsy, bone marrow iron stain, iron stain, bone marrow). In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier; 2013:241-244.

      Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Philadelphia, PA: Elsevier; 2017:chap 30.