Bone marrow biopsy

Whakamātaunga mongamonga

A bone marrow biopsy takes a small sample of bone marrow and looks at it under a microscope to see if anything's wrong. The test helps your doctor confirm your diagnosis and plan any treatment.

The sample is usually taken from the back of your hip bone or very rarely from your breastbone.

Preparing for your bone marrow biopsy

If you're taking blood thinners such as warfarin, dabigatran (Pradaxa) or rivaroxaban (Xarelto) and you have not received instructions on what to do, please contact the Haematology Service using the contact details in your appointment letter. Usually, you'll need to stop the medication for two to five days before the procedure.

Unless it has been prearranged that you'll be having intravenous sedation, you can eat and drink as normal before your procedure.

Cultural needs

For some people, it's important to have their bone marrow returned to them after it has been tested. For example, many Māori choose to have their bone marrow returned. This is so it can be blessed and buried in a significant place. If you would like this option, please speak with your doctor at the bone marrow biopsy procedure.

Sometimes your bone marrow cannot be returned since the laboratory has to use all of it. But speak up if having your bone marrow returned is important to you. The Haematology Service will try to get it back to you wherever possible.

If you have any special needs, it's important that you give at least five days’ notice. Examples of special needs include:

you need an interpreter
you would prefer a female or a male doctor
you would like a karakia during the procedure.

Contact the Haematology Outpatient nurses on (03) 364-0824 if you want:

more information before your procedure
to arrange an interpreter
support from a Māori health worker.

During your bone marrow biopsy

The test will be done by a doctor who will explain the test to you. It takes 20 to 30 minutes to complete so it's a good idea to go to the toilet beforehand.

Before the doctor takes the sample, they will ask you to lie on your side. They will clean the skin over your hip bone and inject a local anaesthetic to numb the area.

The doctor will then pass a small needle through your skin and into your bone. The doctor will draw a sample of your bone marrow fluid up into the syringe. This is called bone marrow aspiration.

You may need a small piece of bone marrow removed. This is called a trephine biopsy. A special type of needle is used to do this. The doctor passes it through your skin into your bone. The doctor then gently turns the needle back and forth and a small piece of bone marrow comes out when they remove the needle.

If you're finding the procedure too painful, you may be given Entonox gas to help you relax and to provide pain relief. If this happens, you shouldn't drive for the rest of the day. If possible, it's best to arrange for someone else to drop you off and pick you up whether or not the gas is used.

After your bone marrow biopsy

You'll need to lie on a bed where nurses will watch you for half an hour or so to make sure you're okay to go home.
You may have a bruise and feel uncomfortable for a few days. Taking mild pain relief such as paracetamol may help. Talk to your doctor or nurse about this.

Possible complications

You may get some minor bleeding from the biopsy site. Your nurse will make sure this has stopped before you leave the hospital.
There is a small risk that the biopsy site will become infected. Before you leave the hospital, you'll be given information on what to watch out for and what to do.
If you're feeling unwell, have a fever or any other concerns related to the procedure, please contact the Haematology Service.

Results

It can take a few weeks for the results of your bone marrow biopsy to come through. When your results are available, your doctor will advise you of them.

Contacting the Haematology Service

For non-urgent nursing advice, phone Haematology Outpatients on (03) 364-0824, Monday to Friday, 7.30 am to 4 pm.

If you're feeling unwell, have a fever or other concerns, contact:

Haematology Outpatients on 021-429-573, Monday to Friday, 7.30 am to 4 pm.
Haematology ward on (03) 364-0660, after hours and public holidays.

Written by the Canterbury Regional Cancer and Haematology Service. Adapted by HealthInfo clinical advisers. Last reviewed February 2023.

Sources

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