BONE MARROW BIOPSY (DR.BORGES)

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1. What is bone marrow?

Bone marrow is a soft part in the centre of the majority of bones where precursor stem cells of our blood cells reside from an individual’s birth.

2. What is the role of bone marrow in our body?

Bone marrow shares a major role in the bodily function. It produces hematopoietic cells which get distributed in the peripheral blood; thus it helps in formation of blood cells and its release into the blood stream.

3. How is the test done?

Sample is collected from chest (sternum) or hip region using specialized bone marrow biopsy needle. It is received in lab in an appropriate fixative which undergoes series of processing steps through a processing unit and permanent paraffin wax blocks are made. From wax blocks, glass slides are made and subsequently stained. Slides are seen under microscope for reporting purposes and biopsy reported is generated.

4. What are hematopoietic or blood cells?

Blood cells are constituents of blood and it includes red blood cells, white blood cells and platelets. Their precursors are present in bone marrow in immature form and from stem cells these constituents of blood get matured for functioning.

5. What are the diseases which affect bone marrow?

Diseases affecting bone marrow vary widely from infections, nutritional deficiencies, idiopathic (cause not known), benign tumours to malignant (cancerous) ones.

6. How would I know that I have a bone marrow disease?

Bone marrow diseases usually but not always gets depicted on peripheral blood (CBC report). Symptoms are many times non- specific which includes fever, weight loss, loss of appetite, weakness, fatigue, bleeding, recurrent infections, lymph node swelling, liver or spleen swelling depending on type of disease affecting the bone marrow. The onset of symptoms can be sudden or chronic and long standing. When complete hemogram with examination of peripheral blood smears and other lab parameters are deranged or abnormal, bone marrow biopsy is performed to arrive at a definitive diagnosis.

7. Does a bone marrow disease affect only adult population?

No. The bone marrow diseases can affect both sexes and wide age range from children to adults.

8. What is the purpose of bone marrow biopsy?

Biopsy helps in diagnosis of haematological disease.

9. Does bone marrow biopsy help only in diagnosis?

It not only helps in diagnosis, but also helps in staging of the disease (to see how severe the cancer is) and to monitor response to treatment. It is a diagnostic as well as a prognostic test.

10. Can I directly ask for bone marrow biopsy if I have chronic symptoms?

No. It is always treating physician’s call. After correlating with other lab parameter, symptoms and clinical findings, the decision of bone marrow biopsy procedure is taken.

11. Do i need to do any other test along with this?

Bone marrow aspiration test is usually added along with biopsy for complete diagnosis of a pathological condition. Aspiration test results give us the percentage of various series of cell lines existing in bone marrow.

12. What are the blood cancers commonly seen?

Acute lymphoblastic leukaemia (ALL), Chronic Lymphocytic leukaemia (CLL), acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML) and Multiple myeloma are the commonly occurring blood cancers. ALL is usually seen in paediatric ages, CLL and multiple myeloma in very elderly age population, AML occurs in young adults and CML is seen in 4^th-5^th decade of life. However there, no hard and fast age cut offs and all blood cancers can arise in different ages.

13. Is undergoing this test very painful?

Yes. It is a painful procedure but the clinician will perform biopsy and collect the sample after giving local anaesthesia.

14. Can the same sample be used to perform any further tests for diagnosis?

Yes. In case the biopsy sample is positive for cancer, same can be utilized to perform further test like immunohistochemistry (IHC), which will give us further information about the type of cancer and its severity.

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