Bone marrow Biopsy

 Bone marrow biopsy (BMB) FAQs! Ever wondered what it's all about? Keep reading... 👀



What makes up a BMB? Usually it includes 2 samples - the aspirate (liquid marrow ðŸĐļ) and the trephine (bone core ðŸĶī)
Why do we need 2 samples? The aspirate allows us to individually look at each BM cell under the microscope 🔎 (e.g. WBCs, RBCs) and classify them via flow cytometry (a method of identifying and measuring pathological cells using their surface markers e.g. CD19 for B-cells)
The trephine lets us look at the way the BM is organised and assess for things like fibrosis and infiltration. We can also apply stains 🖌 (immunohistochemistry) to detect specific cells on the trephine
How is it done? It is a quick (20-30 min) awake procedure using local anaesthetic. It does not require a theatre and is often done at the patient bedside. It is done aseptically using 2 separate needles 💉 (aspirate and trephine).
Where do you take the samples from? Most times we manage to get samples from the posterior iliac crest (on either side). If this is not possible (e.g. mobility issues), we can also access the anterior iliac crest. In rare cases, we may also consider accessing the sternum
Does it hurt? Highly variable! We always try to make it as comfortable as possible with local anaesthetic. Some find it painful, some uncomfortable, some don't feel it at all! For people who need frequent BMBs (e.g. patients w/ acute leukaemia), they often get "easier" over time.

Book Appointment

Can you do it with low platelets or if the patient is on anticoagulants/antiplatelets? Yes. BMBs do not tend to cause significant bleeding, and usually this can be stopped with mechanical measures i.e. pressure
Are there any complications? BMB is a very safe procedure. Complications are usually limited to pain/discomfort, and a small risk of bleeding and infection. Damage to surrounding structures (e.g. nerves and blood vessels) is extremely rare.
How long do results take? ⏱ An aspirate can be processed fairly quickly depending on urgency - sometimes within 24 hours. A trephine can take a bit longer (around 5 days) as it needs to be decalcified and then stained. Special stains (IHC) take longer.
In summary, BMB can be a really helpful test in specific situations and it's safe and generally well tolerated. Let us know if you have any questions - and next time your friendly hematologist is on your ward performing one, go along and see for yourself!

Comments

Post a Comment

Popular posts from this blog

Lung cancer: Indian scenario

Image
 In India Occurrence of lung cancer was once thought to be rare; however, over the years, incidence has been on the rise. Studies from different parts of the country have shown common occurrence of lung cancer. Incidence of the disease differs according to gender, age group and smoking status. Published data suggests that lung cancer contributes 11.3 per cent of all newly detected cancers and represents the most common cause of cancer related deaths, Accounting for 13.7 per cent of total cancer deaths every year there are 68.000 new cases of Lung cancer in India while it also accounts for 63,000 deaths. Lung cancer is more in male patients compared to females. It is the most common type of cancer in male patients in India.  BOOK APPOINTMENT While the data from developed countries is showing declining trend of lung cancer among men, in India, the rates are rising both among male and female population. Incidence of lung cancer increases with age up to sixth decade. A study from...
Read more