Bone Marrow

The procedure known as bone marrow or bone marrow aspiration is the withdrawl of the blood-forming portion of the inner core of bone. This sample is taken for laboratory testing or for transplantation. The procedure involves inserting a special needle into a bone and obtaining marrow by suction or coring it out.

 

Diagnosis of Disease
The marrow, which is soft material in the center of bones contains cells that give rise to red cells, white cells and platelets for blood. The marrow contains a supply of iron, which red blood cells require. If you have a condition that affects your blood cells, a bone marrow aspiration may be done to diagnose the material for abnormal blood counts, or to determine the extent of cancer in the bone marrow. Examination of bone marrow can also detect abnormal proteins, inflammation and/or infection.

Treatments for cancer found elsewhere in the body can be heavily influenced by the condition of the material in the bone marrow. Bone marrow is a proven tool in the diagnosis of cancer and of many uncommon diseases. Some of which include amyloidosis, sarcoidosis, thrombocytopenia, brucellocis and some uncommon causes for anemia.

 

Transplantation
A bone marrow transplant can be used to replace diseased, non-functioning bone marrow with healthy functioning bone marrow (for conditions such as leukemia, aplastic anemia, and sickle cell anemia). Bone marrow transplantation can restore normal function of blood cell production after high doses of chemotherapy or radiation are given to treat a malignancy. This process is often called “rescue” (for diseases such as lymphoma, neuroblastoma, and breast cancer).

In patients with rare genetic disorders, a bone marrow transplant replaces bone marrow with genetically healthy functioning bone marrow to prevent further damage from a genetic disease process (such as Hurler’s syndrome, and adrenoleukodystrophy disorder).

 

Location of Bone Marrow Aspiration
In most cases, the pelvic bone, or the ilium, is the site for obtaining bone marrow. Easily accessible in most patients, it is located on the lower back and often marked by dimples on the skin on each side of the spine. Bone marrow can also be obtained from the bones near the groin or the sternum, at the front of the chest.

 

The Procedure
A local anesthetic is used to numb the are on the surface of the bone. A special needle is inserted through a small incision, less than one-quarter inch, made in the skin. The incision is small enough that no stitches are required. The needle is able to penetrate through the hard, outer shell of bone. A syringe is attached and is used to suction a small amount of the bone marrow liquid out.

While this part of the procedure is only a few seconds, it is usually the most painful. Small nerves inside the bone become momentarily stimulated, resulting in the feeling of discomfort.

For purposes of biopsy, the same needle, with a hollow center is inserted into the bone. As it is turned into the bone structure, small amounts of bone marrow are trapped in the hollow core and can be withdrawn and prepared for examination in the laboratory. The samples are examined by specialized technicians, and physicians, such as hematologists and/or pathologists.

 

Risks
Despite the pain experienced by many patients, the risks of any significant complications from the procedure are extremely rare. However, in some rare cases, bleeding, infection, prolonged pain and side effects from the local anesthetic have occurred.