Bone marrow exam

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What is it about ?

The bone marrow is located in the center of certain bones (canal or medullary cavity). The bone marrow is made up of stem cells: these cells are the source of red blood cells, white blood cells and platelets, made in the bone marrow. A diseased stem cell can cause abnormalities in the blood cells (also called blood cells). In this case, it is necessary to examine the bone marrow, for example if a blood disease (such as leukemia) is suspected. Examining the bone marrow helps to get a better idea of ​​the condition and the effect to be expected from treatment. This test can also be useful in determining the stage of blood cancer.

How is the exam going ?

A bone marrow puncture is done by inserting a hollow needle into a bone to aspirate bone marrow into it for examination. The safest and easiest place to get bone marrow is at the back of the pelvis. If you have ever had to pass rays in this area, the doctor may also prick the breastbone. But this presents some risks. It is a bit more painful and the breastbone can break.

To perform a bone marrow puncture, you will need to lie on your left or right side. The doctor will anesthetize the area, then prick the bone marrow cavity to aspirate bone marrow out of it with a syringe. In children up to 2 years of age, a bone marrow puncture is done in the tibia, a calf bone.

If it is not possible to aspirate enough bone marrow (for example with myelofibrosis, a rare disease in which connective tissue gradually replaces the normal bone marrow), a biopsy should be taken. A bone marrow biopsy involves removing a small piece of bone (containing bone marrow). The person having this test may feel pressure. The exam takes about 10 minutes and is usually painless.

The collected material is sent to the laboratory for further examinations. The results are known after several days to a few weeks, depending on the tests requested.

What can you do ?

If you are taking blood thinners, you may need to stop them temporarily. The doctor will tell you if it is necessary. If you are worried about this examination, you can, in consultation with the doctor, take a sedative. After the examination, you should lie on your back for a while, so that pressure is exerted on the site of the bite. The area may remain sensitive for some time. You can take paracetamol to calm this sensitivity.

Want to know more?

Source

Foreign clinical practice guide ‘Myelogram’ (2000), updated on 01.06.2017 and adapted to the Belgian context on 19.10.2019 – ebpracticenet

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