Haematology
The bone marrow is a spongy tissue, which is found in the centre of bones. The bone marrow is our body’s factory where blood cells are made and then mature.
The bone marrow biopsy allows your doctor (Haematologist) to look at all of the different blood cells which are made in the bone marrow:
- Red cells: carry oxygen around the body
- White cells: help fight infection
- Platelets: stop you bruising and help your blood to clot after a bleed
Why do I need a bone marrow test?
The diagnosis of some blood conditions is made by examining the bone marrow. This involves the removal of a sample of the bone marrow for examination under the microscope. This helps establish a diagnosis and assist in deciding the treatment options that are best for you.
Alternatively, a bone marrow test allows the doctor to assess how you have responded to treatment. There are two parts to the test:
- Aspirate: taking the liquid from inside the bone marrow
- Trephine: taking a small core of the bone marrow to allow us to see the marrow within it’s scaffolding.
Preparation
The procedure is carried out as an outpatient. There are no dietary restrictions before the test; you should eat, drink and take any medication as normal. Most often the back of the hip (pelvis) is used to obtain the samples; occasionally the front of the hip will be used and very occasionally the breastbone.
You will be asked to lie on your side with your legs tucked up towards your chest, but so that you are comfortable.
You can wear your own clothes and normally the procedure takes around 15 minutes, although you will remain in the outpatient department longer.
The procedure
Either a haematology doctor or a haematology nurse specialist will carry out the procedure. The procedure is an outpatient investigation. Please let the doctor or nurse know if you have any allergies to dressings, local anaesthetic or cleaning solutions (eg iodine) before the procedure.
The skin where the biopsy is to be taken will be cleansed and then local anaesthetic will be injected around the site that will numb the area. You may experience a stinging sensation as the local anaesthetic is given; this stinging should soon subside.
The aspirate part of the test involves a special needle being inserted into the bone marrow cavity to remove the liquid bone marrow. As this aspirate is being withdrawn, you may experience a sharp pain going down your leg; this is normal and will pass almost immediately.
The trephine part of the test involves the repositioning of another needle and taking a sample by rotating the needle to retrieve samples of the core of the bone marrow. This gives very different information than the aspirate and is equally as important. In some instances, additional samples may be required, for example if you are taking part in a clinical trial. These samples are sent to the appropriate centre, and can take up to four weeks to return.
Benefits
The benefit of undertaking the bone marrow investigation means that a diagnosis can be made more accurately which can help determine the most appropriate treatment for you. In some instances the investigation is carried out to determine a response to treatment.
What are the risks and, or side effects from the procedure?
Complications are very unusual but may include bleeding, infection and pain. A small, dry dressing will be applied to the area. Later in the day, or the following morning, the area where the sample was taken from may be sore; simple painkillers may be taken. There may be some bruising to the area.
Important
If your biopsy site continues to bleed when at home please contact:
- Haematology day unit: 01642 854273
- Ward 33: 01642 835996 (after hours)
Consent
Following an explanation of the procedure, please feel free to ask any questions. You will be asked to sign a consent form that gives the doctor or haematology nurse specialist permission to proceed. You will receive a copy of this consent form to take away with you.
After the procedure
On completion, pressure will be applied to the site to prevent the formation of a haematoma (bruise) and, to ensure that the wound does not bleed. A small dressing is applied to the site and you will be allowed home.
Follow up
It will take at least two weeks to establish all of the information required to make a treatment plan and a clinic appointment will be made to discuss these. If you have any further questions please contact the haematology nurse specialist.
Contact us
If you require further information, please contact us on:
Telephone: 01642 852763, Monday to Friday, 0800 until 1700
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]