Bone marrow aspiration
Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspirationBone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination.
Bone marrow aspiration is not the same as bone marrow biopsy. A biopsy removes a core of bone tissue for examination.
Bone marrow biopsy
A bone marrow biopsy is the removal of marrow from inside one of your bones. Bone marrow is the soft tissue inside bones that helps form blood cells...
Read Article Now Book Mark ArticleHow the Test is Performed
Bone marrow aspiration may be done in your health care provider's office or in a hospital. The bone marrow is removed from your pelvic or breast bone. Sometimes, another bone is selected.
Marrow is removed in the following steps:
- If needed, you are given medicine to help you relax.
- Your provider cleans the skin and injects numbing medicine into the area and surface of the bone.
- A special needle is inserted into the bone. The needle has a tube attached to it, which creates suction. A small sample of bone marrow fluid flows into the tube.
- The needle is removed.
- Pressure and then a bandage are applied to the skin.
The bone marrow fluid is sent to a lab and examined under a microscope.
How to Prepare for the Test
Tell your provider:
- If you are allergic to any medicines
- If you are pregnant
- If you have bleeding problems
- What medicines you are taking
How the Test will Feel
You will feel a sting and slight burning sensation when the numbing medicine is applied. You may feel pressure as the needle is inserted into the bone, and a sharp and usually painful sucking sensation as the marrow is removed. This feeling lasts for only a few seconds.
Why the Test is Performed
Your provider may order this test if you have abnormal types or numbers of red or white blood cells or platelets on a complete blood count.
This test is used to diagnose:
- Anemia (some types)
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
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- Leukemia
Leukemia
Leukemia is a type of blood cancer that begins in the bone marrow. Bone marrow is the soft tissue in the center of the bones, where blood cells are ...
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It may help determine whether cancers have spread or responded to treatment.
Cancers
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
Read Article Now Book Mark ArticleNormal Results
The bone marrow should contain the proper number and types of:
- Blood-forming cells
- Connective tissues
- Fat cells
What Abnormal Results Mean
Abnormal results may be due to cancers of the bone marrow, including:
- Acute lymphocytic leukemia (ALL)
Acute lymphocytic leukemia
Acute lymphoblastic leukemia (ALL) is a fast-growing cancer of a type of white blood cells called lymphocytes. ALL occurs when the bone marrow produ...
Read Article Now Book Mark Article - Acute myelogenous leukemia (AML)
Acute myelogenous leukemia
Acute myeloid leukemia (AML) is cancer that starts inside bone marrow. This is the soft tissue in the center of bones that helps form all blood cell...
Read Article Now Book Mark Article - Chronic lymphocytic leukemia (CLL)
Chronic lymphocytic leukemia
Chronic lymphocytic leukemia (CLL) is cancer of a type of white blood cells called lymphocytes. These cells are found in the bone marrow and other p...
Read Article Now Book Mark Article - Chronic myelogenous leukemia (CML)
Chronic myelogenous leukemia
Chronic myelogenous leukemia (CML) is cancer that starts inside the bone marrow. This is the soft tissue in the center of bones that helps form all ...
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Abnormal results may also be due to other causes, such as:
- Bone marrow doesn't make enough blood cells (aplastic anemia)
Aplastic anemia
Aplastic anemia is a condition in which the bone marrow does not make enough blood cells. Bone marrow is the soft, tissue in the center of bones tha...
Read Article Now Book Mark Article - Bacterial or fungal infections that have spread throughout the body
- Cancer of the lymph tissue (Hodgkin or non-Hodgkin lymphoma)
Hodgkin
Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.
Read Article Now Book Mark ArticleNon-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL) is cancer of the lymph tissue. Lymph tissue is found in the lymph nodes, spleen, and other organs of the immune system. W...
Read Article Now Book Mark Article - A bleeding disorder called idiopathic thrombocytopenic purpura (ITP)
Idiopathic thrombocytopenic purpura
Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clot...
Read Article Now Book Mark Article - Blood cancer called (multiple myeloma)
Multiple myeloma
Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bone...
Read Article Now Book Mark Article - Disorder in which the bone marrow is replaced by scar tissue (myelofibrosis)
Myelofibrosis
Myelofibrosis is a disorder of the bone marrow in which the marrow is replaced by fibrous scar tissue.
Read Article Now Book Mark Article - Disorder in which the bone marrow produces too many red blood cells (polycythemia) or platelets (thrombocytosis)
- Disorder in which not enough healthy blood cells are made (myelodysplastic syndrome; MDS)
Myelodysplastic syndrome
Myelodysplastic syndrome is a group of disorders in which the blood cells produced in the bone marrow do not mature into healthy cells. This leaves ...
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Risks
There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.
References
Bates I, Burthem J. Bone marrow biopsy. In: Bain BJ, Bates I, Laffan MA, eds. Dacie and Lewis Practical Haematology. 12th ed. Philadelphia, PA: Elsevier; 2017:chap 7.
Choby BA. Bone marrow aspiration and biopsy. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 220.
Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 31.
Bone marrow aspiration - illustration
A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.
Bone marrow aspiration
illustration
Sternum - view of the outside (anterior) - illustration
During a sternal tap, a thin needle is inserted into the sternum (shown here) to withdraw bone marrow.
Sternum - view of the outside (anterior)
illustration
Bone marrow aspiration - illustration
A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.
Bone marrow aspiration
illustration
Sternum - view of the outside (anterior) - illustration
During a sternal tap, a thin needle is inserted into the sternum (shown here) to withdraw bone marrow.
Sternum - view of the outside (anterior)
illustration
Review Date: 6/17/2024
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.