Bone marrow aspiration & biopsy

Bone Marrow Aspiration & Trephine

1. BONE MARROW ASPIRATION & BIOPSY For BS MLT

2. Procedure Written informed consent Position the patient Localize the site. Clean the area with aseptic solution. Inject local anesthetic and fan it out. Check for sensation. F or aspirate: a needle is pushed through the anaesthetized skin into the bone. A syringe is used to draw out some bone marrow aspirate. As the BMA is withdrawn, patient may have a brief, sharp pain in the bone (and into the buttock and leg) For biopsy: a second, thicker, hollow needle is inserted into the bone. This is rotated around as it is pushed slightly forward to force a small sample of bone marrow into the hollow middle of the needle. This may cause some dull pain for a short time. The needle is then taken out and a pressure bandage applied

3. COMPLICATIONS •Allergic reaction to anaesthesia . •Excessive bleeding •Infection •Long-lasting discomfort at the spot where the biopsy was taken

4. Points to be considered in BMA reporting The M:E ratio is the ratio of all granulocytic plus monocytic cells (Myeloid) to all erythroblasts (Erythroid). For all bone marrow aspirates examined, the report should specify the M:E ratio and the percentage of lymphocytes and plasma cells. A differential count of at least 200-300 cells should be performed. If there is any borderline abnormality, e.g. in the number of blasts, lymphocytes or plasma cells, a 500 cell differential count should be courtesy.