Bone marrow biopsy is a procedure that can raise many questions and doubts. What exactly is this procedure? What is its use and why is it so important in the diagnosis of haematological diseases? In this article, we will try to answer these questions by explaining the process of collecting a bone marrow sample and explaining what information can be obtained with this method. Understanding bone marrow biopsies can help you better prepare for the procedure and allay your fears about it.
- Bone marrow biopsy is a medical procedure that allows for an accurate assessment of bone marrow cells and is invaluable in the diagnosis of haematological diseases.
- There are two main types of biopsy: aspiration, which involves the collection of the liquid part of the bone marrow, and trepanobiopsy, involving a piece of bone tissue.
- Biopsy results provide information about the presence of abnormal cells, the severity of the disease and the genetic characteristics of the cells, which influences the choice of therapy.
- A biopsy is recommended when hematopoietic diseases such as leukemia or myelodysplastic syndromes are suspected, and in the case of abnormal blood counts.
- Contraindications to biopsy include blood clotting disorders and inflammation at the site of the planned puncture.
- Although a biopsy is associated with some risk of complications such as pain or bleeding, it is relatively safe and extremely valuable in terms of diagnosis.
- The procedure requires proper preparation of the patient and local anesthesia for comfort during the procedure.
- Biopsy results are crucial in diagnosing rare haematological diseases and help in the selection of appropriate treatment and prognosis of the disease.
What is a bone marrow biopsy?
Bone marrow biopsy is a medical procedure that plays an important role in the diagnosis of haematological diseases. It involves taking a bone marrow sample, which allows for an accurate assessment of its cells. There are two main types of biopsy: aspiration biopsy and trepanobiopsy. Aspiration biopsy involves taking the liquid part of the bone marrow, while trepanobiopsy also involves a fragment of bone tissue. With these methods, doctors can obtain valuable information about the patient’s health.
The process of collecting material for testing is precise and requires appropriate preparation. The most common places are the hip plate or the sternum. After local anesthesia, the specialist inserts a needle into the selected area to collect a bone marrow sample. The biopsy results provide information about:
- the presence of abnormal cells, such as cancer cells,
- the severity of the disease, which is crucial for further treatment,
- genetic characteristics of cells that may influence the choice of therapy.
Thanks to a bone marrow biopsy, it is possible not only to confirm the diagnosis, but also to monitor the effectiveness of treatment and assess the progression of the disease.
Indications for bone marrow biopsy
Bone marrow biopsy is an extremely important diagnostic tool in the case of suspected haematological diseases. Indications for it include, above all, abnormal blood count results, which may suggest the presence of diseases of the hematopoietic system. In situations where the doctor notices a deficiency or excess of peripheral blood cells, such as erythrocytes, leukocytes or platelets, a biopsy can provide valuable information about the cause of these disorders. In addition, the presence of immature forms of cells in peripheral blood is also an indication for this test.
Bone marrow biopsy is also recommended in cases of suspected hematopoietic system cancers and metabolic diseases. It can be invaluable in the diagnosis of rare haematological diseases, where other methods may be insufficient. Thanks to it, it is possible to detect diseases such as leukemia or myelodysplastic syndromes. It is worth noting that bone marrow biopsy allows for the assessment of:
- return of function after bone marrow transplantation
- lytic bone lesions of unknown etiology
- control of haematological treatment
This allows doctors to more accurately determine the type and stage of the disease, which is crucial for further therapy planning.
Contraindications and risks of bone marrow biopsy
Bone marrow biopsy, although it is an extremely valuable diagnostic tool, cannot always be performed. There are some contraindications that should be taken into account before performing this procedure. First of all, patients with blood clotting disorders such as hemophilia should be especially careful. In such cases, it may be necessary to replace the missing clotting factors or transfuse platelet concentrate beforehand. Another contraindication is inflammation of the skin, subcutaneous tissue or bones at the site of the planned puncture. In such situations, it is recommended to choose a different place to collect the material.
Although there are some risks associated with bone marrow biopsy, it is a relatively safe procedure. Possible complications after the procedure include:
- allergic reactions to a disinfectant or anesthetic,
- pain at the injection site,
- prolonged bleeding or hematoma formation,
- Rare development of inflammation.
To minimize the risk of complications, it is important to follow the doctor’s instructions regarding preparation for the procedure and what to do after it. Despite these potential complications, bone marrow biopsy remains an indispensable tool in the diagnosis of rare haematological diseases, enabling precise determination of the type and stage of the disease.
How does the bone marrow biopsy procedure work?
A bone marrow biopsy is a procedure that requires proper preparation of the patient to ensure the safety and effectiveness of the procedure. Before starting the biopsy, the patient is informed about the course of the procedure and possible complications. Then the doctor chooses the appropriate place to collect the material, which is usually located in the area of the posterior or anterior iliac spine. In some cases, especially when the patient has undergone pelvic radiotherapy, material may be taken from the sternum handpiece. Preparation includes:
- disinfection of the skin at the injection site,
- the use of local anesthesia, which covers the skin, subcutaneous tissue and periosteum.
Local anesthesia is crucial for the patient’s comfort and allows for a painless procedure. A few minutes after the anesthetic is administered, the doctor proceeds to the actual biopsy stage.
The process of collecting a bone marrow sample involves inserting a special needle into the selected place. The needle is equipped with a stop that prevents it from being inserted too deeply. The doctor makes rotational movements with the needle to reach the medullary cavity and aspirates the material with the help of a syringe. The procedure usually lasts a few minutes, and after its completion, the puncture site is secured with a sterile dressing. After the procedure, the patient should:
- Stay lying down for a few minutes.
- avoid physical exertion for the rest of the day.
By performing a precise bone marrow biopsy, it is possible to obtain valuable diagnostic information, which is invaluable in the identification of rare haematological diseases.
The importance of biopsy results in the diagnosis of rare haematological diseases
Bone marrow biopsy results provide extremely valuable information that is invaluable in diagnosing rare haematological diseases. With this procedure, a detailed picture of hematopoietic cells and their precursors can be obtained, allowing the assessment of their appearance, genetics and other characteristic features. If abnormal cells, such as cancerous cells, are found, it is possible to determine their origin, which makes it easier to select the appropriate treatment and prognosis the course of the disease. Bone marrow biopsy also makes it possible to assess the so-called bone marrow cellularity, i.e. the richness in various blood cell precursors, which is crucial in the diagnosis of anemia and myelodysplastic syndromes.
A variety of laboratory tests performed on bone marrow biopsy material play an important role in determining the type and stage of the disease. The most important of them include:
- Cytological examination – allows to assess the morphology of cells and identify possible pathological changes.
- Histopathological examination – enables a thorough analysis of the structure of the myeloid tissue.
- Molecular testing – used to identify specific genetic mutations.
- Immunophenotyping – allows to determine the protein profile of cells, which is helpful in the diagnosis of haematological malignancies.
Thanks to these advanced techniques, it is possible to precisely determine the type of disease and its severity, which has a direct impact on the choice of therapeutic strategy and the patient’s prognosis.
Summary
A bone marrow biopsy is an essential medical procedure that allows for an accurate assessment of bone marrow cells. Thanks to it, doctors can diagnose various haematological diseases, such as leukemia or myelodysplastic syndromes. There are two main types of biopsy: aspiration, which involves the collection of the liquid part of the bone marrow, and trepanobiopsy, which also involves a piece of bone tissue. This procedure is precise and requires appropriate preparation of the patient, and the results provide information about the presence of abnormal cells, the stage of the disease and the genetic characteristics of the cells.
Indications for biopsy include abnormal blood counts and suspected hematopoietic cancers. Although biopsy has some risks, such as allergic reactions or pain at the injection site, it is a relatively safe procedure. Biopsy results are extremely valuable in the diagnosis of rare haematological diseases and allow for precise determination of the type and stage of the disease. Thanks to advanced laboratory techniques, it is possible to accurately understand the characteristics of the disease and choose the appropriate therapeutic strategy.
FAQ
Is a bone marrow biopsy painful?
A bone marrow biopsy is usually not painful, as it is performed under local anesthesia. The patient may feel some discomfort or pressure during the procedure, but the pain is minimized through the use of anesthetics.
How long does a bone marrow biopsy procedure take?
The bone marrow sample collection procedure itself usually takes a few minutes. The entire process, including patient preparation and the time needed to rest after the procedure, can take about 30-60 minutes.
Are there alternative diagnostic methods to bone marrow biopsy?
Although bone marrow biopsy is one of the most accurate diagnostic methods for hematologic diseases, there are other tests such as blood counts or imaging tests. However, these methods may not provide as detailed information as a biopsy.
What are the recommendations after a bone marrow biopsy?
After the procedure, the patient should avoid physical exertion for the rest of the day and follow the doctor’s instructions regarding the care of the injection site. It is also important to monitor for possible signs of complications, such as prolonged bleeding or pain.
Can I be active normally after a bone marrow biopsy?
Most patients can return to normal activities the day after surgery. However, it is recommended to avoid intense physical exertion for a few days to allow the puncture site to fully heal.
Are biopsy results available immediately after surgery?
Bone marrow biopsy results are not available immediately. Analysis of the collected material can take from a few days to several weeks, depending on the type of laboratory tests performed.
Is there a risk of infection after a bone marrow biopsy?
Infection after a bone marrow biopsy is rare but possible. To reduce the risk of infection, it is important to follow the rules of hygiene and the doctor’s recommendations regarding the care of the injection site.
How to prepare for a bone marrow biopsy?
Before the procedure, the patient should inform the doctor about all medications taken and possible allergies. In some cases, you may need to stop taking anticoagulants a few days before the procedure.
