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Bone marrow aspirate

Category Haematology
Test background

Bone marrow is a soft fatty tissue found inside the body’s larger bones. It has a honeycomb or sponge-like structure, consisting of a network of fibres filled with fluid. The fluid contains stem cells, blood cells in various stages of maturation, and ‘raw materials’, such as iron, vitamin B12 and folate, that are required for cell production. A variety of bone marrow diseases, cancers such as leukaemia, vitamin and mineral deficiencies, inherited conditions and diseases such as aplastic anaemia, can affect the marrow’s ability to produce an adequate number of each of the different blood cell types and release them into circulation. These diseases may affect the total number of cells produced, the proportion of different cells produced, and/or the function of the cells. Some bone marrow disorders may lead to a deficiency of one or more cell types while others result in excess production of a specific type or of a specific clone of a cell – a single cell that reproduces without regulation.

Clinical Indications

Bone marrow is often assessed in conjunction with red cell indices and reticulocyte count in the diagnosis of a number of conditions, including:

- aplastic anaemia, acute leukaemia (AML/ALL), myelodysplastic syndrome (MDS), chronic myeloid leukaemia (CML), myelofibrosis and essential thrombocythaemia, multiple myeloma, severe thrombocytopenia and/or anaemia and/or neutropenia
- staging of tumours, eg. Hodgkin’s and Non-Hodgkin’s lymphoma, small cell carcinoma of the lung
- assessment of infection in immune-compromised individuals, suspected brucellosis, typhoid fever and other conditions

Sample & container required Bone marrow biopsy - a bone marrow sample collected primarily from the hip bone (pelvis); sometimes collected from the sternum (breast bone) in adults or the tibia (shin bone) in infants.
Sample volume Native films plus aspirated sample sufficient for cytogenetics and immunophenotyping as required.
Turnaround time 3-5 days

Special handling: patient to be administered local anaesthetic, asepsis maintained and sample collection performed by suitably trained physician.