Doctors use bone marrow tests, which usually include a bone marrow biopsy and bone marrow aspiration, to examine the fluid and tissue in the bone marrow. These tests help determine whether cancer or another disease is affecting blood cells or marrow, as well as the extent of the disease. Some changes to blood cells can be detected in marrow samples before they can be seen in blood samples.
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How Are Bone Marrow Biopsy and Bone Marrow Aspiration Done?
A bone marrow biopsy procedure removes a small amount of bone filled with marrow. A bone marrow aspiration removes a liquid sample from the marrow. Both tests are usually performed at the same time in a doctor's office or a hospital.
Marrow and bone marrow samples are usually taken from the hip bone. First, the doctor numbs the area (local anesthesia). Your child may be given a mild sedative or remain awake.
The doctor uses a hollow needle to remove a small amount of marrow cells (aspiration) and a small piece of bone filled with marrow (biopsy). If both tests are being done at the same time, the doctor may either use a different biopsy needle for each test or remove and reposition the same needle. Some patients experience slight bone pain for a few days after the procedure.
The samples are examined under a microscope (cytogenetic analysis) to detect any chromosome changes and other changes in the cells. For patients already undergoing cancer treatment, periodic marrow tests can reveal whether marrow function is beginning to return to normal. This is often done in combination with a white cell differential (also known as "CBC plus differential" or "differential").
Marrow samples can also be used for fluorescence in situ hybridization (FISH), flow cytometry, immunophenotyping, karyotype tests, and polymerase chain reaction.
What Do the Results Mean?
The results give your child’s doctor information that can:
- Confirm a blood cancer diagnosis or a bone marrow disorder
- Determine the cause of severe anemia (low red blood cell count) or thrombocytopenia (low platelet count)
- Detect abnormal chromosomes to determine your child’s risk and to plan treatment
- Evaluate your child’s response to therapy
- Help track your child’s progress during treatment
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