Bone Marrow Aspirate & Biopsy: What you and your child can expect

Children with leukemia or other cancers may need to have a bone marrow aspirate or biopsy to evaluate the status of their leukemia. Here's what you might experience in the clinic or hospital where your child's procedure will be performed.

A bone marrow aspirate and a bone marrow biopsy are not the same thing. According to MedlinePlus:

Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination.

A bone marrow biopsy is the removal of marrow from inside bone.

Bone marrow aspiration can be done at your child's doctor's office or in a hospital. The bone marrow is usually removed from the pelvic or hip bone.

• The health care provider will make sure that you and your child (if old enough) understand and agree to have the procedure done.
• Children may receive anesthesia or medicine to help them relax.
• The health care provider will clean the skin and inject numbing medicine into the area and surface of the bone.
• When the area is numb a special needle is inserted into the bone. The needle has a tube attached to it, which creates suction. A small sample of bone marrow fluid flows into the tube.
• The needle is removed.
• Pressure and then a bandage are applied to the skin. Your health care provider will tell you how long the child should wear the bandage.
• Your child may go to the recovery ward until the effects of the anesthesia wear off. Health care providers may monitor your child's vital signs and the aspiration site to make sure he or she is stable.
• The bone marrow sample will be sent to a laboratory to be examined under a microscope.

The clinic or hospital staff should provide you with discharge instructions. You should ask questions about anything that you don't understand. If your child's procedure was performed in a hospital they may have to go to recovery area or post-anesthesia care unit (PACU). Nurses will monitor your child's vital signs and aspiration site until he or she is stable enough to go home.

Some general instructions for caring for the aspiration site include:

• Keep the bandage dry for 24 hours.
• No showers, baths, swimming or hot tubs.

Call your child's health care provider if you notice:

• Bleeding that soaks the bandage or won't stop when you apply pressure
• A fever that won't go away
• Pain that is getting worse
• Swelling at the aspiration site

Check with your health care provider to see when your child will have a follow up appointment to discuss the results of the bone marrow aspirate and biopsy. The results of this procedure will help determine if you child is in remission or has relapsed. Many chemotherapy treatment plans will vary based on the status of this procedure.