Information for patients having a
bone marrow biopsy
This leaflet provides information for patients having a bone marrow biopsy at Velindre Cancer Centre. It will explain what a bone marrow biopsy is and what to expect on the day the biopsy is taken. The leaflet will also tell you about the possible problems that may occur. Contact telephone numbers are provided at the end of the leaflet.
What is bone marrow?
Bone marrow is the spongy tissue and fluid inside some of the larger bones in the body. The marrow is where you make red blood cells, white blood cells, and platelets from cells called 'stem cells'.
What is a bone marrow biopsy?
A bone marrow biopsy involves taking two samples of your bone marrow. The first part of the test is a bone marrow aspiration. The second part of the test is a biopsy. Although both parts of the test gather cells, the samples are used to give different information.
An aspiration means removing some fluid. A sample of bone marrow fluid is removed so that it can be looked at under the microscope or tested in other ways.
A biopsy is when a small sample of tissue is removed from a part of the body. The sample of bone marrow is then examined under the microscope to look for abnormal cells and tested in other ways.
Why do I need a bone marrow biopsy and aspiration?
The main reason why you may be advised to have these tests is to:
- Confirm the initial diagnosis, for examplelymphoma
- Determine the extent (or stage) of the cancer
- Find out the reason for a low number of red blood cells (anaemia), a low number of white blood cells (leucopenia), or a low number of platelets (thrombocytopenia) in the blood
Where do I go to have my bone marrow test?
You will be asked to go to Rhosyn Day Unit in Velindre Cancer Centre. We will arrange your appointment when you are in clinic. We may also ring you at home to confirm the date and time of the appointment. Please try to be on time for your appointment as there may be 2 or 3 other patients having the procedure done on the same day.
How long will the tests take?
Your appointment should take between 30-45 minutes but please allow at least an hour in case there are any delays.
Can a relative or a friend stay with me?
Onemember of your family or a friend can be with you when you have your bone marrow biopsy. We usually advise that the person accompanying you waits in the waiting room and does not come into the treatment area whilst the procedure is being done. This is due to the size of the room and space constraints.
Can I eat and drink before the biopsy?
Yes, you can eat and drink as normal.
What preparation is needed before the biopsy?
Wewill explain the bone marrow biopsy procedure to you and answer any questions you have. There are minor risks associated with this procedure. We will explain these to you, and they are also listed on page 5. We will ask you to sign a consent form before the biopsy is taken.
Wewill ask you to empty your bladder before the procedure. Please tell us if you have ever had an allergic reaction to local anaesthetic orif you take medicines that affect how your blood clots, such as aspirin or warfarin.
How is the biopsy done?
Bone marrow samples are usually taken from the top of the hip bone (pelvis). This is the bone that you can feel just below each side of your waist at the back.
We will ask you to lie on a couch on your side with your knees bent up towards your chest.
Your hip will be exposed and the healthcare professional will feel for your hip bone with her / his hands. This is to findthe area where the samples will be taken from. The healthcare professional will mark the area with a pen.
We will clean the skin where the samples are to be taken from with an antiseptic fluid.
A local anaesthetic is injected into a small area of skin and tissues just over the bone. This stings a little at first. Once the area is numb a needle is pushed through the anaesthetised skin into the bone to aspirate the bone marrow fluid. We use a syringe to draw out some liquid bone marrow. As the liquid is withdrawn, your may have a brief, sharp pain in your bone, buttock or down your leg.
A second needle is inserted into the bone to biopsy the bone marrow. This needle is thicker with a hollow middle. It is rotated around as it is pushed slightly forward to force a small sample of bone marrow into the hollow middle of the needle. This may cause some dull pain for a short time. The needle is then taken out and a dressing is put over the small wound.
What happens after the test?
We will ask you to lie on your side where the samples have just been taken from. Lying on this side for about 10 minutes helps to apply pressure to the area to avoid bleeding.
What are the risks in having a bone marrow biopsy and aspiration?
There are only a few small risks in having a bone marrow biopsy. These include:
Pain
Although we will give you a local anaesthetic, you may feel pain when the nerve endings around the hip bone are touched by the biopsy needles. Please let the healthcare professionalknow if it is painful and she/he will stop for a few seconds until it settles down again. It is an uncomfortable process and you will feel pressure in your hip bone during the procedure.
Bruising
Bruising mayoccur over the test site which may cause discomfort for a few days (up to 3days in some patients). This can be eased by taking painkillers such as two paracetamol tablets every six hours.
Bleeding
This is usually minor and lying on the side of the test site after the procedure helps to prevent bleeding.
Infection
As with any procedure there is always a small risk of infection. We make every effort to ensure that an aseptic technique is carried out throughout the procedure.
Do I need to take special care when I go home?
To reduce the risk of infection you must leave the dressing in place for 24 hours after the test. You will not be able to shower or bath as you must not get the dressing wet.
The local anaesthetic carries on working for up to 4 hours after the test. You may feel discomfort in your hip when it wears off. You can ease this by taking painkillers.
You may feel tired when you get home. Listen to your body and try and rest for a couple of hours. You can resume your normal activities when you feel ready.
When will I get the test results?
The results may take up to two weeks to come back to the doctor, sometimes longer if they need to do special tests. You will be given the results when you next attend clinic.
Contact telephone numbers
We hope that you have found the information in this leaflet helpful. If you have any further questions please contact:
Hilary Thomas - Clinical Lead Nurse RDU/CDU
02920615888ext 6387 or pager 179
Monday – Friday 9am – 5pm
Or
Simon Lawrence – Senior Radiographer X-ray department
029 2061 5888 ext 6252
Monday – Friday 9am – 5pm
This leaflet has been written by health professionals. The information contained in this leaflet is evidence based. The leaflet has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.
Reviewed June 2011
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