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Tests for myelofibrosis (MF): Bone marrow biopsy
What happens inside the bone marrow: The bone marrow in our bodies is a spongy substance that runs along the inside of our long bones. The marrow acts as a "factory" for making blood cells. Stem cells inside the marrow grow and mature into the blood cells our body uses: platelets, red blood cells and white blood cells. Once the blood cells mature, they leave the bone marrow through the bone and move into our peripheral blood, or blood stream.
What the bone marrow test tells us: Your haematologist may want to look at a sample of your bone marrow - this will give him or her a good picture of your blood-making mechanism. This test is important for people who may have myelofibrosis as it helps confirm the diagnosis. The bone marrow sample is colored with a special stain (reticulin). This will show your haematologist how severe the fibrosis is (see photos of bone marrow below).
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Bone Marrow sections showing fibrosis - H&E stain & Reticulin
How the test is conducted: Your haematologist will take a sample of your bone marrow from the back of your pelvis bone. This is done in a procedure called a bone marrow biopsy. This can be usually be done without a general anaethetic and does not require an overnight stay in hospital.
Your doctor will ask you to lie on your side with your legs curled up. He or she will clean your skin where the biopsy will be taken and numb the area with an injection of local anaesthetic. This can sometimes cause a stinging sensation which only lasts a few seconds. The doctor will insert a needle into the anaesthetised area. You may feel a slight "pulling" sensation as the sample is taken.
For some people, a second sample called a trephine biopsy is required. This involves collecting a "core" of the bone. At this time you may feel an uncomfortable pushing sensation, but it will only last a few moments.
The whole procedure usually takes 20-30 minutes. The site will be covered with a small dressing and you will be asked to lie on your back for a few minutes.
The dressing needs to stay in place for 24 hours and it is best to avoid soaking in the bath during this time. You may experience slight discomfort in the area as the local anaesthetic wears off, which can be helped by taking a simple painkiller such as paracetamol.
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