What Are Bone Marrow Tests?
Bone Marrow Tests are procedures used to examine the bone marrow, the soft, spongy tissue found inside certain bones where blood cells are produced. Bone marrow contains stem cells that develop into red blood cells, white blood cells, and platelets, all of which play essential roles in carrying oxygen, fighting infections, and helping blood clot. Healthy bone marrow is vital for maintaining normal blood cell production and overall health.
Bone marrow testing generally includes a bone marrow aspiration, which removes a small amount of liquid bone marrow, and a bone marrow biopsy, which removes a small sample of solid bone marrow tissue. These tests help diagnose, monitor, and stage a wide range of conditions, including anaemia, leukaemia, lymphoma, multiple myeloma, bone marrow failure disorders, infections, and cancers that have spread to the bone marrow. Bone marrow tests may also be performed to investigate unexplained abnormalities in blood cell counts or to evaluate the effectiveness of ongoing treatment.
How Are The Tests Performed?
Preparation
- Before undergoing Bone Marrow Tests, your healthcare provider will explain the procedure and review your medical history.
- No fasting is usually required unless sedation is planned or instructed by your healthcare provider.
- Inform your healthcare provider about all medications, especially blood thinners, aspirin, or other medicines that affect blood clotting.
- Tell your healthcare provider if you have any bleeding disorders, allergies, or are pregnant.
- Arrange for someone to accompany you home if sedation is used during the procedure.
- You may be asked to sign a consent form before the procedure begins.
Collection
- Bone marrow samples are collected by a trained healthcare professional in a hospital or specialized laboratory.
- The most common collection site is the posterior iliac crest (back of the hip bone).
- The skin is cleaned thoroughly, and a local anesthetic is injected to numb the area.
- During a bone marrow aspiration, a special needle is inserted into the bone to withdraw a small amount of liquid bone marrow.
- During a bone marrow biopsy, a slightly larger needle is used to remove a small core of bone marrow tissue.
- You may feel pressure during the procedure and a brief, sharp pain during the aspiration.
- After the samples are collected, pressure is applied to the site to minimize bleeding, and a bandage is placed over the area.
Lab Analysis
The bone marrow samples are examined by specialized laboratory professionals using microscopic examination, histopathology, and additional laboratory techniques such as flow cytometry, cytogenetic analysis, immunohistochemistry, or molecular testing, depending on the clinical indication. These analyses evaluate the number, appearance, maturity, and distribution of blood-forming cells and help identify abnormal cells, infections, genetic changes, or cancerous conditions affecting the bone marrow.
What Are the Symptoms That Prompt This Test?
You may require Bone Marrow Tests if your blood test results are abnormal or if you have signs and symptoms that suggest a disorder affecting the bone marrow or blood cells. These tests are often performed after other laboratory tests, such as a Complete Blood Count (CBC), indicate unexplained changes in blood cell counts.
Symptoms of Low Blood Cell Production
- Persistent fatigue or weakness
- Pale skin
- Shortness of breath
- Dizziness or light-headedness
- Frequent or recurrent infections
- Fever without a known cause
- Easy bruising or excessive bleeding
- Frequent nosebleeds or bleeding gums
- Tiny red or purple spots on the skin (petechiae)
Symptoms of Bone Marrow Disorders or Blood Cancers
- Swollen lymph nodes
- Unexplained weight loss
- Persistent fever or night sweats
- Bone pain or tenderness
- Enlarged spleen or liver
- Abnormal Complete Blood Count (CBC) results
- Unexplained high or low red blood cell, white blood cell, or platelet counts
- Suspicion of leukaemia, lymphoma, multiple myeloma, or myelodysplastic syndromes
- To monitor the progression of a diagnosed bone marrow disorder or evaluate the effectiveness of treatment
Bone marrow tests may also be performed to determine whether certain cancers have spread to the bone marrow or to investigate unexplained abnormalities found during routine blood testing.
What are Normal Ranges for These Tests?
Unlike routine blood tests, there’s no bone marrow normal range or reference value. Instead, the laboratory evaluates the sample by examining the number, appearance, maturity, and proportion of different blood-forming cells within the bone marrow.
A normal bone marrow sample generally shows:
- Normal production of red blood cells, white blood cells, and platelets
- Healthy bone marrow cellularity appropriate for the individual’s age
- Normal maturation of blood cells
- No abnormal, cancerous, or immature cells
- No evidence of infection, fibrosis, or metastatic cancer
Bone marrow findings are interpreted alongside your medical history, physical examination, Complete Blood Count (CBC) results, and other laboratory investigations.
Bone marrow results must always be interpreted by a qualified healthcare provider or hematologist, as there is no universal “normal range” for these tests. Findings vary depending on the individual’s age, clinical condition, and the reason the test was performed.
“The reference ranges vary depending on the laboratory and the methodology used. Individuals must consult their healthcare provider for correct interpretation of the results.”
What Happens if Test Results Show Abnormal Findings?
Abnormal bone marrow test results may indicate that the bone marrow is not producing blood cells normally or that it has been affected by an underlying disease. Your healthcare provider will interpret the findings together with your symptoms, blood test results, imaging studies, and other diagnostic tests before making a diagnosis.
Bone marrow tests may identify conditions such as:
- Leukaemia
- Lymphoma
- Multiple myeloma
- Aplastic anaemia
- Myelodysplastic syndromes (MDS)
- Myeloproliferative neoplasms (MPNs)
- Bone marrow fibrosis (myelofibrosis)
- Iron deficiency or iron overload
- Certain inherited blood disorders
- Infections involving the bone marrow
- Cancers that have spread (metastasised) to the bone marrow
The tests may also reveal abnormalities in the number, size, or maturity of blood-forming cells, helping healthcare providers determine the cause of abnormal blood counts.
Need Bone Marrow Tests? Book your appointment today for expert diagnostic testing and accurate evaluation of bone marrow health.
