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What is a bone marrow biopsy?
Bone marrow is the spongy tissue located in the middle of your bones where different types of blood cells are made. These cells include red blood cells, white blood cells and platelets.
A bone marrow aspirate is removal of a small amount of the bone marrow tissue in liquid form.
A bone marrow trephine biopsy is removal of a small amount of the bone marrow itself, usually around 1-3cm long.
Why do I need a bone marrow biopsy?
There are many different reasons why your doctor may have suggested this test. Common reasons include to:
- Investigate low blood counts
- Investigate high blood counts
- Look for evidence of bone marrow involvement by disease e.g. lymphoma or myeloma
- Monitor treatment response
If you are not clear about why you need the biopsy, please do not hesitate to ask your doctor who will explain about the procedure and address any concerns you may have.
Who will perform the procedure?
One of the haematology resident doctors will perform the procedure. For outpatients, this is done in the haematology day unit area. For inpatients, the procedure is performed in the patient room on the ward.
What preparation is needed before the biopsy?
As you are required to lie on your side for up to 30 minutes, you should wear comfortable clothes.
t is important to let the doctor know about allergies, including allergies to anesthetic agents. You must also inform the doctor of any medications you take such as blood thinning tablets, e.g. warfarin and aspirin, as these may need to be stopped for a few days before the test. The procedure will be explained in detail beforehand, and you will be asked to sign a consent form stating that you understand what the test involves.
How is the biopsy done?
You will be asked to lie flat and roll over to one side with your knees bent. The skin around the back of the hip will be cleaned, and local anesthetic will be injected into this area. This can sting initially and then will feel numb.
Initially a needle is inserted into the bone and a small sample of liquid bone marrow is removed. Aspiration of this fluid can sometimes cause some discomfort and the doctor will let you know when this is about to happen.
If a trephine biopsy is needed, then this will be done next. A different needle is inserted into the same area. You may experience a pushing sensation which can be uncomfortable but is usually over very quickly. When the needle has been removed, pressure and dressing are applied to the area. This dressing should remain on and kept dry until the following day.
What are the risks?
Complications are not common. The risks to be aware of are:
- Bleeding – if this occurs at the site, it is usually very minor and soon stops. Occasionally the bleeding can be more severe and very rarely a blood transfusion may be needed. Please contact a member of the medical team if you experience persistent bleeding.
- Infection – there is a small risk of infection at the wound site. If the area becomes red, hot, or inflamed, please contact a member of the medical team for advice.
- Pain – there may be pain at the biopsy site for a few days. If this persists or is not managed with simple painkillers, please contact a member of the medical team.
- Damage to structures, such as nerves – this is very uncommon, as the site where we take the biopsy from is well away from the spinal cord and major nerves.
An appointment will be made for you to see the haematology consultant to discuss the results. Depending on the type of tests being performed, results may take up to 2-3 weeks to complete.
Contact information
For appointment queries in Frimley Park Hospital, please contact the secretary team on telephone 0300 613 5715 or email fhft.haematologysecretariesfph@nhs.net.
For appointment queries in Wexham Park Hospital, please contact the secretary team on telephone 0300 615 3418 or email fhft.
If you have questions about the test or your condition
Please contact the haematology Clinical Nurse Specialist (CNS) via the Macmillan Cancer Navigators Monday to Friday 08.30-16.00:
• Tel: 0300 613 3535
• Email: fhft.
Contact us
If you have any queries relating to this information, please contact the Cancer care service.
About this information
Service:
Cancer care
Reference:
HH/040
Approval date:
2 January 2026
Review date:
2 January 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.