Bone marrow biopsy

A bone marrow biopsy is a procedure frequently performed to aid in the diagnosis and staging of many blood conditions.

Your treating doctor will discuss the reasons for this test before arranging this procedure. This procedure is performed as a day case by either a Haematologist or Haematology Registrar. Over 1,000 bone marrow biopsies are performed each year at Peter Mac.

Types of bone marrow biopsies

The bone marrow biopsy is almost always taken from the back of the pelvis bone where the large bone of the iliac crest is readily and safely accessible. Rarely, there may be a need to do the biopsy from the front (anterior iliac crest), or even the sternum (breast bone).

Preparing for your procedure

  • It is recommended that you fast from midnight on the day before your procedure, unless you definitely know you will not be receiving or choosing sedation of any kind.
  • It is advisable to wear loose fitting comfortable clothing.
  • Please inform the staff if you are taking anticoagulant drugs (“blood thinners”) such as warfarin, clexane, clopidogrel or other anticoagulants.
  • Please arrange for someone to assist you travelling home after the procedure.

Note: driving and operating machinery is prohibited for the remainder of the day, after any type of sedation.

On the day

Where to go

Imaging 5th floor, reception 5B Imaging via the main lifts.

The front inquiry desk will be happy to direct you. Remember not eat or drink anything before your procedure.

Premedication

Local anaesthesia is used for all patients. It gives good pain cover and many patients find this sufficient without requiring additional sedation or analgesia.

The team will discuss with you and aid your choice regarding a premedication with either an inhaler or an intravenous injection (if medically fit):

  • Inhaled sedation (methoxyflurane/Penthrox, also known as the ‘green whistle’) – an inhaled light acting pain relief.
  • Intravenous sedation (midazolam) - provides quicker and deeper sedation/drowsiness for patients. This is administered through a cannula which is inserted into an arm vein.
  • Oral sedation (diazepam or lorazepam) is rarely used – It is a light sedation given to reduce anxiety and discomfort.

During your procedure

You will be positioned on your side. Local anaesthesia will be given to numb a small area of the skin and on top of your pelvis bone. A very small cut in the skin is made (less than 0.5cm). A needle is inserted through the cut and a liquid sample (aspirate) is withdrawn and this is used to make slides, and perform other molecular and immunological tests. A core of tissue (trephine) the size of a matchstick is then removed. The procedure is reasonably quick, but at times can be uncomfortable. Most patients find the discomfort mild and tolerable.

All patients undergoing a bone marrow biopsy are asked to participate in the Peter Mac Tumour Bank Programme. Additional samples of blood and bone marrow are taken at the same time as the procedure and are either used fresh or stored as a potential resource for future research. You may be asked to sign a separate consent form for participation in this programme. Participation in the programme is voluntary and you can opt out anytime.

After your procedure

You will be required to remain under the care of nursing staff until you are discharged. If you receive intravenous sedation you will be required to stay for a minimum of two hours prior to being discharged to a carer.

After 24 hours the small waterproof dressing on the biopsy site can be removed and a clean dressing reapplied. A spare dressing and instructions will be given to you on the day of your procedure. 

What to bring

Please remember to wear loose fitting comfortable clothing.

Please bring a list of your medications and any letters or pathology request slips that your doctor may have given you for this procedure.

Side effects and possible complications

Bruising and discomfort over the area are common for up to one week post biopsy. Bleeding or infection at the biopsy site are rare complications. Please notify your doctor if the site becomes red, hot or if bleeding persists.

Amnesia (no memory) of the procedure this is common with intravenous sedation. Your normal memory will not be affected once the sedation has worn off.

Safety and sedation: you are advised not to drive, operate machinery or consume alcohol for the remainder of the day.

If you have any problems following the procedure please contact the Cancer Imaging Day Centre on (03) 8559 5510 during work hours, your treating doctor or the haematology registrar after hours via the Peter Mac switch board on (03) 8559 5000.

Getting your results

The results will be sent to your doctor in two to seven days.

Referral information

For patients

Your general practitioner or specialist will organise relevant referrals for a Bone marrow biopsy.

For medical professionals

Bone marrow biopsy bookings are to be booked through the Cancer Imaging Access Coordinator, on

Phone: (03) 8559 5142 

Fax: (03) 8559 5519

Or alternatively by email: [email protected]

They must be made by close of business the day prior. Numbers are limited, but urgent cases/ additions to the daily list should be discussed with the duty Laboratory Haematology Registrar or the access coordinator.

Minimum patient information required

a. Patient’s full name, DOB

b. UR number

c. Diagnosis/ clinical notes/ indication for procedure

d. Name of Treating Team, requesting Doctor & contact details including pager number & the primary consultant

f. Notification of VRE, MRSA and/or any infections requiring isolation is highly essential

For general information on referring patients to Peter Mac see referrals.

Location

Cancer Imaging Day Centre

level 5, reception 5B Imaging

Peter MacCallum Cancer Centre

305 Grattan Street

Melbourne, 3000

Contact

Imaging

Phone: (03) 8559 5510

Fax: (03) 8559 5519

Related experts

Head: Haematopathology
Consultant Haematopathologist
Consultant Haematologist
Haematologist and Disease Group Lead: Myeloproliferative disorders/chronic myeloid leukaemia