Bone marrow aspiration and biopsy are standard tools used in the hematology laboratory to aid in the evaluation and diagnosis of peripheral blood abnormalities. Some of these abnormalities include: cytopenias such as neutropenia, thrombocytopenia and anemias. Bone marrow aspiration and biopsies are also used by hematology/oncology specialists in the diagnosis of leukemias, dysplastic syndromes, and proliferative syndromes. A bone marrow aspiration and biopsy may also be a part of the evaluation of some metabolic and genetic disorders, assessment of fever of unknown origin (FUO), as well as when assessing failure to thrive (FTT) in the pediatric setting.
A bone marrow aspirate sample is obtained by inserting a needle into the bone marrow space and withdrawing using a syringe. A portion of this liquid marrow is smeared for staining and evaluation under light microscopy. Liquid marrow samples are also transferred to evacuated blood collection tubes containing the anticoagulants required for the types of assays desired. It can be sent for various types of laboratory assessment including: immunophenotyping, cytogenetic evaluation, and molecular analysis.
While bone marrow aspirations and biopsies are usually obtained by the hematologist or oncologist, they are evaluated and interpreted by a hematopathologist with the assistance of the laboratory technologists who prepare and stain the smears. In many laboratory settings the technologists also perform the bone marrow differentials.