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Bone Marrow Aspiration and Biopsy

This information will explain your bone marrow aspiration and biopsy procedure at Memorial Sloan Kettering Cancer Center (MSK).

Bone marrow is a thick liquid substance inside your bones. Your blood cells are made in your bone marrow.  

Your doctor may need to take a sample of your bone marrow in order to see:

  • How many blood cells you have.
  • If there are any cancer cells or scar tissue in your bone marrow.
  • If the chemotherapy that you are getting has affected your bone marrow cells.
  • If you have had an allogeneic stem cell transplant, your doctor may take a sample to see how much of your bone marrow is from your donor. 

There are 2 different procedures to get a sample of bone marrow. In a bone marrow aspiration, your doctor, nurse practitioner, or physician assistant (healthcare provider) will use a narrow needle to draw out some of the bone marrow liquid. In a bone marrow biopsy, your healthcare provider will use a slightly larger needle to take a small sample of the bone marrow core and the surrounding bone. If you are having both procedures done, the aspiration will be done first. 

The procedure usually takes 15 to 20 minutes.

Before Your Procedure

Tell your healthcare provider if you are:

  • Allergic to chlorhexidine (used in disinfectants) or local anesthetics (medications used to make an area numb).
  • Sensitive or allergic to latex.
  • Sensitive or allergic to any adhesives such as tape.

You do not need to do anything to prepare for your procedure. You can eat beforehand.

During Your Procedure

Most often, the back of the hip bone is used as the site of the procedure. You will lie on your stomach or on your side for this. In rare cases, the breastbone or the front of the hip bone is used as the site of the procedure. In this case, you will lie on your back.

Your healthcare provider will clean your skin with chlorhexidine solution. He or she will inject you with anesthesia [such as procaine (Novocain®) or lidocaine] to numb the site of your procedure. You may feel some burning during the injection. This will go away in a few seconds.

Once the anesthesia starts working, your healthcare provider will insert a needle into your bone. This can be done using different techniques. Your healthcare provider will talk with you about which option is right for you. You will feel pressure as the needle is inserted. If you are experiencing pain, tell the person doing the procedure. 

If you are having a bone marrow aspiration, your healthcare provider will draw a small amount of bone marrow through the needle. This is the “aspirate” or “aspiration.” You may feel a pulling or drawing sensation moving down your leg at this time. Some people feel very brief pain when the aspirate is taken. The anesthetic cannot help with this pain.

If you are (als0) having a bone marrow biopsy, a separate needle will be used. It will be inserted into the  same area as the aspiration. A small core of bone and bone marrow will be taken. You may feel more pressure during this procedure

Depending on the type of cancer you have, you may need to have the bone marrow aspiration and biopsy done on both your right and left hip bones on the same day.

When your procedure is finished, a small dressing will be applied to the area(s).

After Your Procedure

  • You may feel some soreness at the area where the bone marrow was taken. Ask your healthcare provider about medication to relieve the discomfort. Do not take aspirin or products that contain it for 24 hours after your procedure. Ask your nurse for the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs). It lists the medications you should not take because they can cause bleeding. If you must take aspirin after your procedure, speak with your healthcare provider. 
  • Some people feel slightly light-headed for a few minutes after the procedure. This will go away.
  • Some people experience numbness in the leg or foot on the side of the procedure immediately after the procedure. If this happens, tell your healthcare provider. Do not try to stand up on your own. This usually goes away in a few minutes.
  • Keep your dressing on for 24 hours.
  • Do not shower or bathe for 24 hours after your procedure. After 24 hours, you can take a bath or shower.
  • If you have bleeding at the site of your procedure, apply pressure and call your healthcare provider.