Leukemia is a cancer of the blood, bone marrow and lymphatic system. In leukemia, the bone marrow produces an abnormally large amount of white blood cells and the white blood cells do not function properly. Symptoms of leukemia include fatigue, easy bruising, low grade fever, swollen lymph nodes and excessive sweating during the night. The Mayo Clinic states that many people overlook the symptoms of leukemia because it mimics symptoms of the flu or other illnesses.
Significance
If a person is suspected of having leukemia, a doctor will test his blood to determine if levels if white blood cells and platelets are abnormal. If blood tests come back abnormal, a doctor may perform a bone marrow aspiration test to rule out or diagnose leukemia. A bone marrow biopsy is often repeated in a patient with leukemia to evaluate his response to treatment.
Before the Test
Bone marrow biopsies are usually done on an outpatient basis and no preparation is needed. Although not all bone marrow biopsies are painful, a doctor may prescribe a pain reliever to be taken before the procedure. Anti-anxiety medication may also be given to reduce anxiety.
Procedure
Most bone marrow biopsies take marrow from the pelvis. The patient will be instructed to lie on his stomach. The doctor will clean the area with soap and then inject a local anesthetic, usually lidocaine, into the area to numb the tissue under the skin. The doctor will make a small cut in the skin to allow the needle to enter. The biopsy needle passes through the bone with a twisting motion. After the needle has passed through the top layer of bone, the doctor will use a syringe to collect a sample of bone marrow cells. The doctor then will move the needle farther into the marrow and collect a sample of bone marrow called a core biopsy. This sample is a solid piece of marrow that contains fat and bone fibers. The doctor will then pull the needle out, apply pressure to minimize bleeding and bandage the wound.
Risks
Risks of bone marrow biopsies are minimal, but complications can occur. Patients with low platelet counts are at risk for excessive bleeding. Individuals with low immune system function are at increased risk for infection. If the biopsy needle breaks in the bone during the procedure, infection and bleeding can occur.
After the Test
The area where the needle was inserted can become sore and bruised after the procedure. The marrow is sent to the lab, and a doctor will look check for abnormalities. Bone marrow results are usually obtained within a few days.
