Bone Marrow Tests

Why this test may be ordered

• You had abnormal results on other blood tests, such as a complete blood count (CBC) or a blood smear.
• You have signs and symptoms, and a medical history that could mean you have a bone marrow disease.
• You have certain types of cancers that involve your blood and bone marrow, and your health care provider needs to know how much cancer is in your body (cancer staging).
• You have a type of cancer in another part of your body that commonly spreads to bone marrow.
• You are being treated for a condition that affects your blood or bone marrow, and your provider needs to find out how well your treatment is working.

Preparation and collection

You may need to stop taking certain medicines before this test. Tell your provider about everything you take. Do not stop taking any medicines unless your provider tells you to. Tell your provider if you have a bleeding disorder. You may need to fast (not eat or drink) for a few hours before the procedure. Plan to have someone take you home after the test because you may be drowsy if you are given medicine to relax or sleep.

Bone marrow samples are usually taken from the back of the hip (iliac crest) using two procedures performed together: bone marrow aspiration (removes a small amount of fluid and cells) and bone marrow biopsy (removes a small piece of bone and marrow). The collection takes about ten minutes.

After a bone marrow aspiration and biopsy you may feel stiff or sore where the sample was taken. This usually goes away in a few days. Serious symptoms are very rare, but may include increased pain or discomfort, redness, swelling, bleeding, or other fluids leaking from the area, or fever. If you have any of these symptoms, call your provider.

Understanding results

It may take several days or even weeks to get your bone marrow test results. Your provider may have ordered many different types of tests on your sample, so your results often include a lot of complex information.

• Normal: Normal amounts of healthy blood cells are being produced. Limitation: Your provider can explain what your results mean. Next step: If you have already been diagnosed with a disease that involves your bone marrow, your test results may show how well your treatment is working or whether your treatment is causing side effects that affect your bone marrow.
• Abnormal: There may be a bone marrow disorder, blood disorder, or certain types of cancer (such as leukemia, multiple myeloma, or lymphoma). Limitation: Your provider can explain what your results mean. If your test results are not normal, you may need to have more tests to confirm a diagnosis or to decide which treatment would be best for you. Next step: Your provider will discuss further testing and treatment options based on the specific findings.

• After the test you may feel stiff or sore where the sample was taken, which usually goes away in a few days.
• Serious symptoms are very rare but may include increased pain, redness, swelling, bleeding, or fluid leaking from the needle site, or fever. If you have any of these, call your provider.
• Certain pain relievers, such as aspirin, could increase your risk of bleeding.

What to do next

Your provider can explain what your results mean. If results are not normal, you may need more tests to confirm a diagnosis or to decide which treatment would be best for you.

• Why do I need a bone marrow test?
• What should I do to prepare for the procedure?
• What are the risks and side effects?
• When will I get my results and who will explain them to me?
• Will I need any follow-up tests?

Evidence source

U.S. National Library of Medicine: Bone Marrow Tests