Introduction
Biopsies of bone marrow are performed to extract the marrow from the bone. Bone marrow is the soft tissue found within bones that aids in the formation of blood cells. It may be found in the depressions of most bones. A bone marrow biopsy differs from a bone marrow aspiration.
A tiny needle is injected into the bone for the biopsy. The bone marrow sample is extracted and transported to a lab to be examined under a microscope. The lab that receives the sample will usually test it to see if it is producing healthy blood cells. They may also examine the number of blood cells generated to see whether there is a decline or rise.
In a few circumstances, it is not advised. It will aid in the diagnosis of a wide spectrum of hematological and bone illnesses.
What Is a Bone Marrow?
Bone marrow is a soft, fatty tissue found inside bones that stores stem cells that eventually become blood cells. These hematopoietic stem cells contribute to the generation of new blood cells. When the blood cells are fully mature and working properly, they exit the bone marrow and enter the bloodstream. They are made up of red blood cells, which carry oxygen throughout the body, white blood cells, which fight infections in the blood, such as bacteria, and platelets, which aid in the clotting of the blood when injured.
Bone marrow biopsy can determine whether the bone marrow is healthy and producing enough blood cells. These techniques are used by doctors to identify and monitor blood and marrow illnesses, such as certain malignancies and other conditions of unknown cause. A tiny needle is placed into the bone to do the biopsy. The procedure does not usually cause any complications.
What Is Bone Marrow Biopsy?
A bone marrow biopsy is a process in which a sample of solid bone marrow tissue is extracted using a specific needle. This may reveal a lot and help determine whether cell production is normal, and if there are enough platelets, it can even suggest whether the person has chromosomal problems. However, the essential point is that they can typically confirm a blood cancer or bone marrow problem.
Why Is Bone Marrow Biopsy Required?
A bone marrow biopsy is performed for a variety of reasons. They may aim to detect many things. The tests are primarily intended to:
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Confirm a blood cancer or bone marrow disease diagnosis.
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Find out what is causing the severe anemia or thrombocytopenia (low platelet count).
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Detect aberrant chromosomes to assess the risk and plan the therapy.
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Aid in tracking the progress during therapy.
When Is a Bone Marrow Biopsy Indicated?
A bone marrow biopsy is used to diagnose and possibly determine the cause of:
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Anemia.
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Leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, pancytopenia, and polycythemia are all blood cell diseases in which too few or too many of various types of blood cells are formed.
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Blood or bone marrow cancers, such as leukemias, lymphomas, and multiple myeloma.
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Cancers have spread from another part of the body, such as the breast, to the bone marrow.
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Hemochromatosis (when the body absorbs an excessive amount of iron from the food taken).
What Are the Preparations Prior to Bone Marrow Biopsy?
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Before the procedure, the medical professionals will take a complete medical history, particularly if the patients have a history of bleeding issues or if they are taking any drugs or supplements.
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The patient should notify the doctor if she is pregnant.
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The patient's vital signs will be taken, including blood pressure, heart rate, respiration rate, and temperature.
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Depending on the location chosen by the doctor, the patient may be requested to arrange himself or herself on the stomach or on the side.
What Are the Procedures for Bone Marrow Biopsy?
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During the procedure, firstly, the doctor will select a location for the bone marrow extraction. The rear of the hip bone (iliac crest of the pelvis) is commonly used, although it can also be done from the breastbone (sternum), lower leg bone (tibia), or backbone (vertebra).
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The selected location will now be cleaned. After the location has been cleaned, sterile clothes will be put around it. It is critical that the patient does not touch this region once it has become sterile.
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A local anesthetic will be administered to the affected area. This is done to numb the spot.
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Immediately after the area has become numb, the healthcare practitioner makes a tiny incision at the biopsy site. Typically, bone marrow aspiration comes first. The medical practitioner will obtain a liquid sample of the bone marrow cells; this is usually done with a syringe.
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After the bone marrow biopsy follows the aspiration, a biopsy needle is significantly bigger than an aspiration needle. The healthcare professional inserts the needle into the bone, spins it, and extracts a bone and tissue sample. There will be some bleeding at the point of insertion, so the pressure is applied for a few minutes. After that, a sterile bandage is placed.
How Should Bone Marrow Biopsies Be Followed Up?
After the procedure, patients must do a few things to avoid further complications.
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It is critical to keep the biopsy site clean and dry.
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For at least 24 hours, refrain from bathing or showering.
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Leave the bandage on for as long as the clinician instructs.
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Only take pain relievers as advised by the healthcare provider.
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For the next 24 hours, avoid taking Aspirin or Aspirin-containing products, as it may increase the risk of bleeding.
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If patients have any of the following symptoms, such as fever, discomfort near the biopsy site or redness, swelling, bleeding, or abnormal discharge from the biopsy site; contact the health care professionals.
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If the needle site bleeds, apply pressure on it.
What Are the Contraindications of Bone Marrow Biopsy?
In a few circumstances, bone marrow biopsies are not recommended and safe. Those are:
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Hemorrhagic disorders such as congenital coagulation factor deficiencies such as hemophilia.
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Disseminated intravascular coagulation.
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Allergic reaction to anesthesia.
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Skin infection at the sampling site.
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Bone disorders such as osteomyelitis or osteogenesis imperfecta.
What Are the Complications Involved in It?
Bone marrow biopsies are generally safe; however, there is a risk of consequences. Some of the most prevalent issues include:
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Bruising and pain at the biopsy site.
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Bleeding from the biopsy site for an extended period of time.
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Infection close to the biopsy site.
If one may have other health issues at the time of the bone marrow biopsy, this may increase the chance of difficulties.
Conclusion
It is apparent that, though a bone marrow biopsy is a short technique used by clinicians to collect and evaluate a sample of bone marrow, it will aid in the diagnosis of a variety of blood illnesses, including some malignancies. The treatment frequently involves discomfort, although this pain is bearable when done correctly and under expert supervision. The operation poses a little risk, particularly for those using blood thinner medications. It is, however, the only technique to gain sufficient precision regarding some significant causes of altered blood cell creation.
