What Are Bone Marrow Tests?
Bone marrow tests are used to check whether your
bone marrow is healthy. These tests also show whether your bone marrow is
making normal amounts of blood cells.
Bone marrow is the sponge-like tissue inside the
bones. It contains stem cells that develop into the three types of blood cells
that the body needs:
- Red blood cells carry oxygen through the
body.
- White blood cells fight infection.
- Platelets (PLATE-lets) stop bleeding.
Another type of stem cell, called an embryonic
(em-bre-ON-ik) stem cell, can develop into any type of cell in the body. These
cells aren't found in bone marrow.
Overview
Doctors use bone marrow tests to diagnose blood and
bone marrow diseases and conditions, including:
- Conditions in which a person produces too few or
too many of certain types of blood cells
- Problems with the structure of red blood
cells
- Bone marrow disorders, such as myelofibrosis
(MI-e-lo-fi-BRO-sis)
- Some cancers, such as leukemia (lu-KE-me-ah)
Bone marrow tests also help doctors determine how
severe a cancer is and how much it has spread in the body. The tests also are
used to diagnose fevers and infections.
The two bone marrow tests are aspiration
(as-pi-RA-shun) and biopsy.
Bone marrow aspiration usually is done first. For
this test, your doctor removes a small amount of fluid bone marrow through a
needle. He or she may have some idea of what the problem is, and the sample
gives him or her useful information about the cells in the marrow.
A bone marrow biopsy is a followup test. It's done
when an aspiration doesn't give needed information. Or, it's done when the
doctor wants to examine the bone marrow structure itself. For a bone marrow
biopsy, your doctor removes a small amount of bone marrow tissue through a
larger needle.
Outlook
Bleeding and infection are the two most common risks
of bone marrow tests, but they're rare. The tests are fairly simple, and
they're safe for most people.
In some cases, these tests aren't safe for people
with certain bleeding disorders (like
hemophilia).
Your doctor can tell you whether a bone marrow test is safe for you.
Who Needs Bone Marrow Tests?
You may need bone marrow tests if your doctor
suspects that you have a blood or bone marrow disease or condition. These
diseases and conditions include:
- Myelodysplastic (MI-e-lo-dis-PLAST-ik) syndrome.
This is a group of diseases in which your bone marrow doesn't make enough
normal blood cells.
- Neutropenia (NU-tro-PE-ne-ah). This is a
condition in which you have a lower than normal number of white blood cells in
your blood.
-
Anemia
(uh-NEE-me-eh). This is a condition in which you have a lower than normal
number of red blood cells, or the red blood cells don't have enough of an
iron-rich protein that carries oxygen from the lungs to the rest of the body.
Bone marrow tests also are used to diagnose
aplastic
anemia. This is a rare and serious condition in which bone marrow stops
making enough new blood cells.
- Myelofibrosis. This is a serious bone marrow
disorder that disrupts normal production of blood cells and leads to severe
anemia.
- Thrombocytopenia (THROM-bo-si-to-PE-ne-ah). This
group of conditions occurs when your body doesn't make enough platelets and
your blood doesn't clot as it should.
- Essential thrombocythemia
(THROM-bo-si-THE-me-ah). This is a disease in which your bone marrow makes too
many blood cells, especially platelets.
- Leukemia. This is a cancer of the white blood
cells. Types of leukemia include acute and chronic leukemias and multiple
myeloma.
You also may need bone marrow tests if you have
other types of cancer. These may include breast cancer that has spread to the
bone or Hodgkin's and non-Hodgkin's lymphomas (which are cancers of a
particular type of white blood cell).
Bone marrow tests help show what stage the cancer is
in. That is, the tests help doctors know how serious the cancer is and how much
it has spread in the body.
Bone marrow tests also can show what's causing a
fever. The tests may be used for people who have diseases in which their immune
systems aren't working properly. They're also used for patients who may have
uncommon bacterial infections.
What To Expect During Bone Marrow Tests
Bone marrow aspiration and biopsy take about 20
minutes each. Before the test(s), the doctor or nurse will tell
you what will happen. Your breathing, heart rate, and pain will be monitored
throughout the test.
These tests are generally done on the pelvic bone.
Part of this bone is accessible in most people on the lower back. If your
doctor uses that part of the pelvic bone, you will lie on your stomach for the
test. Aspiration also can be done on the breastbone.
The area on your body where the doctor will insert
the needle is cleaned and draped with a cloth. Your doctor sees only the site
where the needle is inserted. He or she numbs the skin at the site and then
makes a small incision (cut). This makes it easier to insert the needle into
the bone. Stitches may be needed to close the cut after the test.
For bone marrow aspiration, your doctor inserts the
needle into the marrow and removes a small amount of fluid bone marrow. You may
feel a brief, sharp pain. The fluid that's removed from the bone marrow is
taken to a lab and studied under a microscope.
If your doctor decides to do a bone marrow biopsy,
it's done after the aspiration. For the biopsy, your doctor uses a needle to
remove a small amount of the bone marrow tissue. Thin sections of this tissue
are studied under a microscope.
During both tests, it's important for you to remain
still and as relaxed as possible.
What To Expect After Bone Marrow Tests
After the bone marrow test(s), the
nurse holds a bandage on the site where the needle was inserted until the
bleeding stops. Then he or she puts a smaller bandage on the site. Most people
can go home the same day.
After 24 hours, you can take off the bandage. Call
your doctor if you develop a fever, have a lot of pain, or see redness,
swelling, or discharge at the site. These are signs of infection.
Expect mild discomfort for about a week. Your doctor
may tell you to take an over-the-counter pain medicine.
What Do Bone Marrow Tests Show?
Bone marrow tests show whether your bone marrow is
making enough healthy blood cells. If it's not, the results can tell your
doctor which cells are unhealthy and why.
Bone marrow tests are an important tool. They're
used to diagnose a variety of blood and bone marrow disorders, including
anemia
and certain kinds of cancer. They're also used to find out how serious a cancer
is and how much it has spread to other areas of the body. Bone marrow tests
also help doctors determine the cause of fevers and infections.
Your doctor combines information from your bone
marrow test with information from a physical exam, blood tests, and other tests
such as imaging scans and x rays. This information helps your doctor
diagnose your condition and plan how to treat it.
What Are the Risks of Bone Marrow Tests?
Bleeding and infection are the two most common risks
of bone marrow tests, but they're rare.
To prevent bleeding from the site where the needle
was inserted, don't do any heavy lifting or vigorous exercise for a few
days.
To prevent infection, don't shower or bathe for the
first day. After 24 hours, you can take off the bandage. Call your doctor if
you develop a fever, have a lot of pain, or see redness, swelling, or discharge
at the site. These are signs of infection.
Expect mild discomfort for about a week. Your doctor
may tell you to take an over-the-counter pain medicine.
Bone marrow tests are safe for most people. In some
cases, these tests aren't safe for people with certain bleeding disorders (like
hemophilia).
Your doctor can tell you whether bone marrow tests are safe for you.
Key Points
- Bone marrow tests are used to check whether your
bone marrow is healthy. These tests show if your bone marrow is making normal
amounts of blood cells.
- Bone marrow is the sponge-like tissue inside the
bones. It contains stem cells that develop into the three types of blood cells
that the body needs: red blood cells, white blood cells, and platelets.
- Bone marrow tests help doctors diagnose blood and
bone marrow diseases and conditions.
- Bone marrow tests also are done to help doctors
determine how severe a person's cancer is and how much it has spread in the
body. These tests also are used to diagnose fevers and infections.
- The two bone marrow tests are aspiration and
biopsy. For these tests, your doctor uses a needle to remove a small amount of
fluid bone marrow (for aspiration) or bone marrow tissue (for biopsy). A biopsy
is a followup test that's done when an aspiration doesn't give needed
information or when the doctor wants to look the bone marrow structure.
- Bone marrow tests take about 20 minutes. You may
feel a brief, sharp pain as the needle is inserted into the bone marrow. It's
important for you to remain still and as relaxed as possible during the
tests.
- Bone marrow tests show whether your bone marrow
is producing enough healthy blood cells. If it's not, the results can tell your
doctor which cells are unhealthy and why.
- Your doctor combines information from your bone
marrow test(s) with information from a physical exam, blood tests,
and other tests such as imaging scans and x rays. This information helps
your doctor diagnose your condition and plan treatment.
- Bleeding and infection are the two most common
complications, but they're rare. In some cases, these tests aren't safe for
people with certain bleeding disorders (like
hemophilia).
Your doctor can tell you whether bone marrow tests are safe for you.
Links to Other Information About Bone Marrow
Tests
Non-NHLBI Resources
Clinical Trials
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