This patient information explains what happens before, during and after a bone marrow biopsy. The nurse or doctor will talk through the process with you on the day.
What is bone marrow?
Bone marrow is the soft/spongy part inside some of your larger bones. Bone marrow produces cells in your body including:
- Red cells to carry oxygen
- White cells to fight infection
- Platelets to stop bleeding
Why do I need a bone marrow biopsy?
A bone marrow biopsy is often needed to look into abnormal blood tests or abnormal scans to help with your diagnosis. It is also used to keep track of a diagnosed condition and assess response to treatment.
What is a bone marrow biopsy?
This is a minor invasive test carried out usually by a trained nurse or by a doctor. The test has two parts:
- Aspiration (removal of liquid bone marrow)
- Trephine (removal of a small piece of bone)
Both samples are taken with a special needle.
How is the test done?
You will be asked to lie on your side with your knees bent up towards your stomach. Sometimes you might be asked to lie on your front.
The biopsy is taken from the back of the pelvic bone near the hip. Only your lower back will be uncovered.
The area over the hip bone will then be cleaned and a numbing solution (anaesthetic) will be injected under the skin which might sting for a few seconds. Once the area is numb, the bone marrow sample is taken.
Will the test hurt?
Some people feel some pressure as the needle is inserted and some people feel a pulling sensation as the liquid sample comes out. The feeling lasts for a short time. It is important that you tell us if you do have serious pain at any time. Occasionally gas and air is used if you need it.
What happens after the bone marrow test?
After this, some pressure will be applied to the biopsy site to stop any bleeding followed by a dressing. You will then lie on your back for 5 minutes to make sure any bleeding has stopped. If you feel ok, you can go home.
Keep the dressing in place for 2 to 3 days. This should be enough time for a scab to form over the wound.
If you notice fresh bleeding apply some pressure and change the dressing.
Please avoid getting the plaster wet. You can shower after 24 hours but you should avoid bathing or swimming for 48 hours.
You may feel tender and sore in your hip and leg for a few days. You may also feel some tingling in your leg. This is normal and will go away in a few days. You can take paracetamol to manage this.
Going back to work
You are allowed to go back to work but light activity is advised for a few days to reduce bleeding risk and in case you have any pain.
The samples will be sent to several laboratories. Some results will be available quickly but others may take several weeks.
Preparing for your biopsy
Consent: you will be asked to sign a consent form if you agree to the test. You will also have time to ask any questions before doing this.
Language/interpreter assistance: please tell us at the time of the booking if you need an interpreter to translate.
Allergies: the nurse or doctor will ask you if you have an allergy to local anaesthetic.
Blood thinners: please let us know if you take blood-thinning medicine to stop blood clots (Warfarin, Apixaban, Edoxoban etc). We will tell you if you need to stop them before the test and when to restart.
Bleeding or clotting problems: please tell us if you have had any problems with bleeding or clotting after a procedure in the past.
Mobility: if you have issues with standing or walking then please bring any equipment you use to help you get from a chair to a bed.
You will normally need to allow approximately 1 hour for the whole procedure.
What problems might occur after a bone marrow biopsy?
As with medical procedures, there is a small chance that a problem may occur.
You should seek advice by calling one of the numbers below depending on where your biopsy was done.
Please contact us if you are worried about the following:
Bleeding – mild bleeding and a little bit of bruising is normal. If the bleeding lasts for a while even after applying pressure and changing the dressing then please call us.
Infection – the skin around the site can become red, hot and tender or you have a fever of 37.5 and above.
Pain that does not go away after a few days with paracetamol.
Please note:
If you require an assessment then you may be asked to attend the ward or assessment unit. If unfortunately there is not capacity on the day for you to be seen then you may be asked to attend your nearest urgent treatment centre (UTC) or GP surgery.
Haematology Assessment Unit (9am to 5pm)
Lincoln County Hospital
01522 307841
Bostonian Ward (24 hours)
Pilgrim Hospital
01205 445347 or 446148
Waddington Unit (24 hours)
Lincoln County Hospital
01522 307199 or 307198
DRIVING POST PROCEDURE
The procedure involves local anaesthetic so patients are safe to drive themselves to and from hospital. However, should you require sedation (gas and air) then it is safer for someone to drive you home.