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Thursday, May 22, 2008

Bone marrow test Q&As

I'm to have a bone marrow test. Can you tell me more about this?

A bone marrow test is a test used to diagnose and assess blood disorders and cancers such as leukaemia, lymphoma and myeloma. Doctors may also sometimes use it in other types of cancer, to check whether any cancer cells have spread into the bone marrow.

There are two types of bone marrow test; an aspirate and a biopsy (trephine).

  • Bone marrow aspirate – some fluid and cells are from taken inside the bone marrow for testing.
  • Bone marrow biopsy (trephine) – a small (1–2 cm) cylindrical core of bone marrow is taken for testing.

You may have both of these tests done at the same time, with the aspirate taken first and then the biopsy sample. Sometimes only an aspirate is done. The aspirate gives the doctor bone marrow cells to test and the biopsy shows the structure of the bone marrow.

Bone marrow

Bone marrow is the fluid and spongy material that fills some of our bones. It is where the white cells, red cells and platelets found in our blood are made.

Bone marrow samples are usually taken from the hip-bone (pelvis). Occasionally a bone marrow aspirate may be taken from the breast-bone (sternum).

Before the test

Before the test your doctor will explain what will happen and will answer any questions you have. If you are worried about having the test let your doctor know. Some people, who feel very worried about having a bone marrow test, can be given a short acting sedative. This works to make them feel more comfortable and less worried during the procedure. If you have a sedative you won’t be able to drive for several hours afterwards so it’s best if you have someone who can take you home after the test.

How the test is done

A bone marrow test can be done as an out-patient or while you are staying in hospital. You don’t need to have any special preparations beforehand. It usually takes about 15 – 20 minutes to have the test.

If you are having a sample taken from the hipbone you will be asked to lie on your side with your knees tucked up towards your chest. Once you are comfortable the skin is cleaned with an anti-bacterial fluid. Sometimes the fluid feels a bit cold on the skin.

After cleaning the area the doctor will inject some local anaesthetic into your skin and around the tissue covering the hipbone. This will numb the area. You might notice some stinging from the anaesthetic when it is being injected. But, once it has had time to work you shouldn’t feel any pain around the area. If you do feel pain during the test let the doctor or nurse know so that more anaesthetic can be given.

Once the area is numb the doctor will put a needle through the skin and into the spongy area inside the bone. When the needle is in place the doctor will draw some fluid and bone marrow cells into a syringe. Some people feel a slightly strange sensation in their leg or toes when the fluid is being taken. But, this only lasts for a few seconds. The needle is then taken out.

A slightly thicker needle is used if you are also having a biopsy sample taken. The doctor will put the needle into the same area the aspirate was taken from and remove a small piece (1–2cm) of bone marrow. You shouldn’t feel pain when this is happening but you will feel some pressure and pushing.

After the test

Once the bone marrow test is over a small dressing will be put over the area and you will be asked to lie on your back for about 15 – 30 minutes. This helps stop any bleeding from the site. Most people are able to go home soon afterwards. But, if you have had sedation you will have to stay in the department until the effects wear off.

You should keep the dressing on and the area dry for the next 24 hours. This is to prevent bleeding and infection. When the anaesthetic wears off you will probably feel some aching around the area where the sample was taken from. This can be relieved with taking simple painkillers such as paracetamol for a few days. Your doctor will recommend what painkiller is best for you.

Possible problems

It is rare to for a bone marrow test to cause problems but occasionally they do occur.

The two main problems that could happen are:

  • Bleeding at site where the bone marrow was taken from. This risk is greater for people who have low numbers of platelets in their blood. If you notice fresh bleeding from the site after having the test put pressure on the area (by pressing on it) to help stop the bleeding and contact the hospital for advice.
  • Infection – If the skin around the site becomes red, hot and tender this may be a sign of infection. Contact the hospital for advice.
Via: http://www.cancerbackup.org.uk

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