Bone marrow puncture

Valeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.

More about the experts All content is checked by medical journalists.

In a bone marrow puncture, a tissue sample is taken from the bone marrow. The tissue sample is used by the doctor to diagnose diseases of the blood and the hematopoietic system. It is rarely obtained for therapeutic purposes and used in stem cell therapy. Read all about bone marrow aspiration, how it works and the risks it entails.

What is a bone marrow puncture?

With bone marrow puncture (bone marrow puncture), bone marrow is removed from the pelvic bone - the posterior upper iliac crest - or rarely from the sternum (puncture) with a special puncture needle. The doctor sucks in bone marrow cells (aspiration), which are then examined more closely. In the laboratory, the different stages of maturity of the blood cells can be seen under the microscope. In this way, conclusions can be drawn about diseases of the blood and the hematopoietic system.

The bone marrow sample is very rarely prepared for a stem cell donation. If the doctor does not succeed in aspirating bone marrow cells, one speaks of a punctio sicca, a dry puncture.

Bone marrow

The bone marrow fills the inner cavities of bones and is responsible for the production of new blood cells. All blood cells arise from the same so-called stem cells, which are constantly renewing themselves. Blood cells include red blood cells (erythrocytes, main task: oxygen transport), white blood cells (leukocytes, main task: immune defense) and platelets (thrombocytes, main task: blood clotting). The development of stem cells into mature blood cells takes place in the bone marrow and can be traced under the microscope using various intermediate stages. In healthy people there are only mature blood cells in the blood itself.

Bone marrow biopsy

In contrast to bone marrow puncture, with a bone marrow biopsy a hollow needle is inserted into the bone marrow, rotated and a cylindrical piece is punched out. This bone marrow sample is then cut thinly and viewed under a microscope. In this way, the doctor can examine not only individual cells, but the entire tissue structure.

When do you perform a bone marrow puncture?

Basically, a bone marrow puncture is always necessary if the doctor suspects a disease of the blood and the hematopoietic system or would like to monitor its progress. A bone marrow puncture is done:

for diagnosis and follow-up of anemia (anemia)
for the diagnosis and follow-up of various forms of leukemia (disease of the white blood cells)
to diagnose or monitor the progress of bone marrow aplasia (reduction in all blood-forming cells) or polycythemia vera (increase in all blood-forming cells)
if bone marrow metastases are suspected (spread of tumors from other organs)
to obtain stem cells for therapy

What do you do with a bone marrow puncture?

Before the bone marrow puncture, your doctor will ask you about previous illnesses and discuss with you which medication you are taking. Especially with blood-thinning medication, it is important to take breaks before the bone marrow puncture, otherwise bleeding can occur.If necessary, he will give you a sedative and pain reliever.

For a bone marrow puncture at the iliac crest, the patient lies on his side and bends his legs; for a removal from the sternum, he lies on his back. The procedure is performed under local anesthesia. The doctor first inserts the puncture needle through the skin and the hard bone substance into the bone marrow. Then the bone marrow is sucked in with a syringe. The needle is then withdrawn and a light compression bandage is applied.

The removed material is spread on a slide and stained (bone marrow smear). This makes it easy to see and count the cells under the microscope.

What are the risks of a bone marrow puncture?

Jerky aspiration of the bone marrow can cause pain. This short, sharp pain disappears quickly and can be reduced with suitable painkillers. In addition, the following complications can occur with a bone marrow aspiration in rare cases:

Bleeding and infection at the puncture site
Injury and inflammation of neighboring organs and tissue structures
rare: respiratory or cardiovascular disorders when taking sedatives or painkillers

What do I have to consider after a bone marrow puncture?

Bone marrow puncture is a short, outpatient procedure. As a rule, your pulse, blood pressure and other values are monitored for about an hour afterwards and your doctor will discuss how to proceed. If you have been given a pain reliever or sedative for the bone marrow aspiration, you must not drive or use machines. On the day of the bone marrow puncture, you should take some physical effort.

Tags: prevention diet Diagnosis