BONE MARROW PROCEDUREDARAKHSHAN SALEEM

1

CONTENTS• Terminology• Types• Prior sites• Reasons to collect• How to collect specimen• Complications• Results

2

TERMINOLOGY

• Bone marrow is the spongy tissue found inside

your bones.

• Aspiration means the doctor or nurse sucks some

bone marrow cells up into a syringe

• A bone marrow trephine means that they remove

a 1 or 2cm core of bone marrow in one piece.

3

Also known as

• Bone Marrow; Bone Marrow Examination

• Formal name: Bone Marrow Aspiration;

Bone Marrow Biopsy

4

Types of bone marrow

1 Produces RBCs, WBCs and platelets

2 Red colour from the HB in

the RBCs

3 Cells mature and migrate into sinusoids

to enter the circulation

4 Highly vascular

1 Produces fat cartilage, bone

2 Cells mature and migrate into sinusoids

3 Gets its yellow colour from

carotenoids in the fat droplets

4 Paucity of vasculature

WBM

RBM

5

6

PRIOR SITES

• The most frequent site for obtaining bone marrow is the pelvic bone, known as the ilium.

• Other sites include the front of the pelvic bone near the groin and the sternum at the front of the chest.

7

Prior sites

8

Why it is done• Anemia, or a low red blood cell count

• Bone marrow diseases, such as myelofibrosis or myelodysplastic

syndrome

• Blood cell conditions, such as leukopenia or polycythemia

• Cancers of the bone marrow or blood, such as leukemias or lymphomas

• Hemochromatosis, a genetic disorder in which iron builds in the blood

• infection, such as sepsis

9

The doctor can also determine the cause of some infections,

diagnose tumors, determine how far a disease, such as

lymphoma, has progressed or spread, and evaluate the

effectiveness of chemotherapy or other bone marrow active

drugs

10

Morbidity and mortality chances

• The most common side effects, in order of

decreasing frequency, were the following:

• Haemorrhage(most common)

• Needle breakage

• Infections

11

COLLECTION FOR BM

12

Tools used for BMC

13

A bone marrow aspiration and biopsy is

usually done by a haematologist, medical

oncologist, internist, or pathologist, or by a

specially trained technologist.

14

TELL YOUR DOCTOR IF YOU:

Are taking any medicines.

Are allergic to any medicine, including anesthetics.

Have any bleeding problems or take blood-thinners,

such as aspirin, clopidogrel (Plavix), or warfarin

(Coumadin).

Are or might be pregnant.15

• To aspirate bone marrow fluid a needle is pushed

through the anaesthetised skin into the bone. A syringe is

used to draw out some liquid bone marrow. As the liquid

is withdrawn, your may have a brief, sharp pain in your

bone (and into the buttock and leg if the pelvic bone is

used).

16

• To biopsy the bone marrow a second, thicker, hollow

needle is inserted into the bone. This is rotated around as it is

pushed slightly forward to force a small sample of bone

marrow into the hollow middle of the needle. This may cause

some dull pain for a short time. The needle is then taken out

and a pressure bandage applied to prevent bleeding

17

VIDEO

18

SAMPLES

BIOPSY

ASPIRATE

19

COMPLICATIONS

•Allergic reaction to anaesthesia.

•Excessive bleeding

•Infection

•Long-lasting discomfort at the spot where the

biopsy was taken

20

• :

• The M/E ratio—this is short for myeloid/erythroid ratio. This

calculation compares the number of myeloid cells (WBC precursors

• Differential—determines whether cells in each lineage (WBC, RBC,

platelet-producing cells) show orderly and complete maturation, and

whether the cells are present in normal proportion to one another.

21

• Presence of any abnormal cells, such as leukemic or tumor

cells.

• Cellularity—the volume of cells is compared to the volume of

other components of the bone marrow, such as fat.

• The structure of the bone marrow, including the sponge bone

(trabecular bone)

22

 Leukemia,multiple myeloma

 Bone marrow disorders

 Myelodysplastic syndrome (MDS)

 Lymphoma, breast lung cancer

Myelofibrosis

23

REPROT

24

25

26