This test checks whether there are cancer cells in your bone marrow.
You might not need to have a bone marrow test if you have already had a PET-CT scan.
What is a bone marrow test
Bone marrow is spongy tissue and fluid that is inside your bones. It makes your blood cells. A doctor or specialist nurse removes a sample of bone marrow, usually from your hip. Doctors then look at this under a microscope.
You have the test in the outpatient department of the hospital. You have a local anaesthetic to numb the area. This means you are awake, but the test shouldn't be painful.
Some people prefer to have some sedation before the test so that they are a bit drowsy. Some hospitals may use gas and air (Entonox) to relax you instead of sedation.
Types of biopsy
There are 2 main types of bone marrow test:
- bone marrow aspiration
- bone marrow trephine biopsy
Aspiration means the doctor or nurse sucks some liquid bone marrow up into a syringe.
A bone marrow trephine means that they remove a 1 or 2cm core of bone marrow in one piece.
You usually have both of these tests done at the same time. They give some of the same information to the doctor, but there are differences. The bone marrow trephine shows the structure of the bone marrow inside the bone, whereas the aspiration takes just the bone marrow cells.
Preparing for your bone marrow test
Check your appointment letter for how to prepare for your bone marrow test.
You are usually able to eat and drink beforehand. Take your medicines as normal.
If you are taking any blood thinning medicines you might need to stop these before the test. Your doctor will tell you when to stop taking them.
Your doctor will ask you to sign a consent form once they have given you information about the procedure. This is a good time to ask any questions you have. When you arrive at the clinic a staff member will ask you to take off your clothes and put on a hospital gown.
You usually lie on your side with your knees tucked up into your chest. First the doctor or nurse cleans the area with some antiseptic fluid, which can feel cold.
Then you have a local anaesthetic injection into the skin over the biopsy site. When the area is numb, the doctor or nurse puts a thin needle in through the skin. It goes into the bone, where the marrow is. The needle going into the hip bone can be painful but this only lasts a short time.
The doctor or nurse sucks a small amount of liquid bone marrow into the needle, using a syringe. You feel a pulling sensation when they start drawing the bone marrow cells out. Some people have a sudden, sharp pain.
They take this needle out and put a slightly thicker one in. The doctor or nurse turns the needle back and forth while pushing it further into the marrow. The aim is to get a small amount of marrow out in one piece. Once it is in far enough, they gently pull out the needle, containing its core of marrow.
The whole test takes 15 to 20 minutes.
What to expect when you have a bone marrow test
Your bone marrow is the spongy substance in the centre of the bones where the blood cells are made.
You may have a bone marrow test if you have a cancer which affects the bone marrow such as leukaemia, lymphoma or myeloma. if your doctor thinks your bone marrow may contain cancer cells that have spread from another type of cancer or you have a non-cancerous condition.
There are two types of tests. A bone marrow aspiration which takes some bone marrow cells and a bone marrow biopsy which takes samples of the bone marrow and gives more information about its structure.
Usually your doctor takes the sample from the back of your hip bone but you can have a bone marrow aspiration from your breast bone.
You have the test lying on a couch. You may have a sedative beforehand to make you sleepy. The doctor then injects some local anaesthetic to numb the area.
For a bone marrow aspiration they put a needle through your skin and into your bone. Then using a syringe they draw out some liquid bone marrow. You may feel a pulling sensation as they do this.
For a biopsy your doctor uses a slightly bigger needle to take the sample of bone marrow. They turn and push this needle to get the sample. This can be painful as the needle goes in but it doesn’t last for long.
You usually go home about half an hour after the test. If you had sedation you need to wait until you are fully awake. This can take a few hours.
Afterwards your hip will ache for a few days. Taking painkillers helps.
You may also have some bruising. Rarely you may have some slight bleeding from the site. Press on it if you do and if it doesn’t stop contact the hospital.
There is a small risk of infection. Tell your doctor if you have a temperature or the biopsy area becomes red and sore.
You may have some tingling in your leg which will also wear off with time.
After your bone marrow test
If you have a sedative, you need to stay at the hospital for a few hours until it has worn off. And you need someone with you so that you don't have to go home on your own. You can go home that day if you are feeling well enough.
The area is looked at by the nurses before you go home. You have a dressing over the area, which you should keep on for 24 hours. If you notice any bleeding, apply pressure to the area. You can do this by lying on your back. Contact the hospital if the bleeding doesn't stop.
After the test, your hip might ache for a couple of days. You may need some mild painkillers such as paracetamol to take at home.
A bone marrow test is a safe procedure but your nurse will tell you who to contact if you have any problems afterwards. Your doctors will make sure the benefits of having a bone marrow test outweigh these possible risks.
You might have some bleeding afterwards. If you notice bleeding when you’re at home and it carries on for more than 15 minutes, contact the hospital.
There is a small risk of infection in the test area. Let your doctor know if you have a temperature or the area becomes red and sore.
Getting your results
You should get your results within 1 or 2 weeks. You normally get them at your next clinic appointment.
Waiting for test results can be worrying. You might have contact details for a specialist cancer nurse. You can get in touch with them for information and support if you need to. It may help to talk to a close friend or relative about how you feel.