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.

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).

• 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.

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.

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 A needle is inserted through the cut and a liquid sample (aspirate) is withdrawn and this is used to make slides, and perform other molecular and immunological tests.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.

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

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.

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.