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Bone Marrow Aspiration & Biopsy Test

Last updated March 19, 2018

Approved by: Maulik P. Purohit MD, MPH

The Bone Marrow Aspiration and Biopsy Test is a procedure that allows for the removal and examination of the bone marrow.

What are the other Names for this Test? (Equivalent Terms)

  • Bone Marrow Biopsy Test
  • Bone Marrow Test
  • Bone Marrow Trephine Test

What is Bone Marrow Aspiration & Biopsy Test? (Background Information)

  • Bone marrow is the spongy tissue inside bones. There are 2 kinds of bone marrow - red and yellow. Normally, red marrow is the main site of blood cell production, or hematopoiesis. Yellow marrow is mainly responsible for fat storage
  • The blood cells include:
    • Red blood cells, which transport ‘gases’ such as oxygen
    • White blood cells, including neutrophils, lymphocytes, and plasma cells, which are important to the immune system
    • Megakaryocytes, which fragment to form platelets and which recruit collagen-producing fibroblasts to the scene of an injury. Platelets clot blood and also recruit fibroblasts
  • These diverse cells develop from myeloid stem cells, inside the bone marrow. This process is mediated by different signals that steer the growth and division of the stem cells, down different pathways
  • Problems with bone marrow can impair many of the vital functions it provides to the body. This includes oxygen transport, immunity, and blood clotting
  • The Bone Marrow Aspiration and Biopsy Test is a procedure that allows for the removal and examination of the bone marrow. It is used to assess bone marrow health. This is important in detecting bone marrow cancers and blood cell diseases
  • Bone marrow is usually taken from the hip, breast, or leg bones, because these bones contain red bone marrow the most

What are the Clinical Indications for performing the Bone Marrow Aspiration & Biopsy Test?

The clinical indications for performing a Bone Marrow Aspiration and Biopsy Test are:

  • Monitor treatment of bone marrow disease
  • Monitor treatment of leukemia
  • Monitor effects of bone marrow suppressants
  • Deficient or abnormal red blood cells that is marked by:
    • Fatigue
    • Pale appearance
    • Difficulty adapting to changes in altitude
  • Deficient or abnormal white blood cells that is marked by:
    • Frequent and persistent infections
    • Fever
    • Headaches
  • Deficient or abnormal platelets that is marked by:
    • Persistent bleeding
    • Easy bruising
    • Presence of pinprick bleeds (petechiae)

How is the Specimen Collected for Bone Marrow Aspiration & Biopsy Test?

Following is the specimen collection process for Bone Marrow Aspiration and Biopsy Test:

Sample required: Bone marrow

Process: Insertion of a needle into a marrow-containing bone.

Preparation required: No special preparation is needed prior to the test.

What is the Significance of the Bone Marrow Aspiration & Biopsy Test Result?

Following is the significance of the Bone Marrow Aspiration and Biopsy Test:

Increased neutrophils may indicate:

  • Acute myeloblastic leukemia
  • Chronic myeloid leukemia

Decreased neutrophils may indicate:

  • Aplastic anemia
  • Monocytic and lymphoblastic leukemia

Increased reticulocytes (red blood cell precursors) may indicate:

  • Loss of red blood cells
  • Response to Vitamin B12 therapy

Decreased reticulocytes may indicate:

  • Sickle-cell anemia
  • Hereditary spherocytosis

Increased plasma cells may indicate:

  • Cancer
  • Liver disease or cirrhosis
  • Connective tissue disorder
  • Allergic reaction
  • Infection
  • Macroglobulinemia
  • Ulcerative colitis

Increased megakaryocytes may indicate:

  • Persistent bleeding
  • Infection
  • Megakaryocytic myelosis
  • Myeloid leukemia
  • Pneumonia
  • Polycythemia vera

Decreased megakaryocytes may indicate:

  • Agranulocytosis
  • Liver disease or cirrhosis
  • Pernicious aplastic anemia
  • Radiation therapy

Increased myeloid to erythrocyte ratio (M:E ratio) may indicate:

  • Bone marrow failure
  • Infection
  • Leukemoid reactions
  • Myeloid leukemia

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Certain factors may interfere with the results of the Bone Marrow Aspiration & Biopsy Test. These include recent blood transfusions and iron therapy
  • This test is not recommended for individuals with known bleeding disorders

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

The following article link will help you understand Bone Marrow Aspiration & Biopsy surgical procedure:


References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 12, 2014
Last updated: March 19, 2018