Bone Marrow Biopsy

Bone marrow aspiration and biopsy: in this procedure, a hollow needle is inserted in the hip or breastbone, and bone marrow, blood and a small piece of bone are removed.  These are examined by a pathologist under a microscope to look for abnormal cells.

Bone Marrow Biopsy

The same sample it is normally used for bone marrow cell morphology, flow cytometry, fluorescent in situ hybridization, cytogenetics, and gene mutation test; the mutations currently tests are Jak 2, MPL, and CALR.  A Jak-2 gene mutation is often found in patients with polycythemia vera, essential thrombocythemia, or primary myelofibrosis.  MPL or CALR gene mutations are found in patients with essential thrombocythemia or primary myelofibrosis.

Bone Marrow Bx


Bone marrow aspiration & biopsy Indications

  • Unexplained anemia, abnormal red cell indices, cytopenias or cytoses
  • Abnormal peripheral blood smear morphology suggestive of bone marrow pathology
  • Diagnosis, staging, and follow-up of malignant hematological disorders (e.g. leukemias, MDS, Myeloproliferative disorders, lymphomas, myeloma, amyloidosis, mastocytosis)
  • Suspected bone marrow metastases
  • Unexplained focal bony lesions on radiological imaging
  • Unexplained organomegaly or presence of mass lesions inaccessible for biopsy
  • Microbiological culture for investigations of pyrexia of unknown origin or specific infections, e.g. military tuberculosis, leishmaniasis, malaria
  • Evaluation of iron storesInvestigation of lipid/glycogen storage disorders
  • Exclusion of hematological disease in potential allogeneic stem cell transplant donors


The information in this document does not replace a medical consultation. It is for personal guidance use only. We recommend that patients ask their doctors about what tests or types of treatments are needed for their type and stage of the disease.


  • American Cancer Society
  • The National Cancer Institute
  • National Comprehensive Cancer Network
  • American Academy of Gastroenterology
  • National Institute of Health
  • MD Anderson Cancer Center
  • Memorial Sloan Kettering Cancer Center
  • American Academy of Hematology


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