Bone Marrow Aspiration

A bone marrow aspiration is a procedure that takes a small sample of liquid from your bone marrow. Your bone marrow is squishy tissue and liquid in the middle of your bones. A hematologist or an oncologist may do this procedure to diagnose conditions that affect your bone marrow, including:

• Blood cancers, like leukemia, lymphoma or myeloma
• Blood disorders, like anemia, iron overload or low levels of white blood cells

How does bone marrow aspiration work?

A hematologist or oncologist will use a thin hollow needle and syringe to draw out a small sample of liquid from your bone marrow. A medical pathologist will examine the sample under a microscope.

How do I prepare for a bone marrow aspiration?

Your healthcare provider will discuss specifics with you, but in general, you should:

• Tell them about any medications you take. They may ask you to stop taking certain medications before your procedure.
• Let them know if you’re very anxious about having a bone marrow aspiration. They may give you medication before the test to help you feel more relaxed and less anxious.
• Arrange to have someone take you home after the procedure if you receive sedation.

What happens during a bone marrow aspiration? 

Your healthcare provider will check your vital signs. They may give you medicine to help you relax or ease any discomfort you may have. They will help you get into position on the treatment table. You may lie on your side or stomach. Next, your provider will:

1. Clean the skin covering the back of your hipbone.
2. Give you an injection of local anesthetic. This numbs the area and the surface of the bone where they insert the biopsy needle.
3. Make a small cut in your skin to insert a thin, hollow needle into your pelvic bone.
4. Attach a syringe to the needle. They’ll use the syringe to withdraw a small amount of bone marrow liquid.
5. Remove the needle and syringe.
6. Place a bandage over the area.

A bone marrow aspiration usually takes about 30 to 45 minutes. You’ll return home the same day of a bone marrow aspiration. Depending on the type of medicines your healthcare provider uses, you may need to wait for the effects to wear off. Someone may need to drive you home after the procedure.

After a bone marrow aspiration, you’ll need to keep the area around your bandage clean and dry for at least 24 hours. Your care team will explain when you can remove the bandage.

Risks and side effects

You may have some pain for a few days in the area where the needle went into your skin. You may feel back pain when you bend over or pain that extends down the back of your leg. Many people also develop mild bruises on their lower back or buttocks in the first week after a bone marrow aspiration.

Bone marrow aspirations are typically safe. But there may be uncommon, but potential risk of:

• Allergic reaction to anesthesia
• Bleeding
• Infection

When should I know the results?

It may be a few days up to a few weeks before your healthcare provider receives test results. Timing depends on the laboratory tests that your provider requests. For example, they may ask a medical pathologist to do tests like:

• Flow cytometry
• FISH
• Karyotype test
• Next-generation sequencing, which identifies genetic mutations in cancer

What type of results do you get and what do the results mean?

Test results will vary depending on the reason why you have a bone marrow aspiration. Your healthcare provider will explain what the test shows, what the results mean and any next steps.

When should I call my doctor?

Call your healthcare provider right away if you have a fever or notice issues around the needle insertion site, like:

• You have cream-colored or white discharge.
• The site bleeds more than you expect.
• The site feels swollen and warm to your touch.

How painful is a bone marrow aspiration?

A bone marrow aspiration may cause some discomfort. For example, you may feel a stinging sensation when your healthcare provider injects local anesthetic into your skin. You may also feel a shooting pain in your hip and leg as your provider draws out bone marrow liquid.

What is the difference between aspiration and biopsy?

Both are procedures to test your bone marrow. The difference is that a bone marrow aspiration takes a sample of the liquid part of your bone marrow. A bone marrow biopsy takes a sample of the solid, spongy part of your bone marrow. Often, providers do a bone marrow biopsy when they do a bone marrow aspiration.