Bone Marrow Aspiration and Biopsy

Bone marrow aspiration and bone marrow biopsies are procedures which may be performed on patients with pediatric retinoblastoma if bone scans and other testing has indicated that cancer has spread to the bones. Bone marrow aspiration and bone marrow biopsies will help physicians to determine whether cancer has penetrated the marrow of the bones. These procedures may be painful and often require sedation, so these tests are usually performed at the same time.

Bone Marrow Aspiration and Biopsy Procedure

When a patient goes in for a bone marrow aspiration and bone marrow biopsy, the patient is often sedated. In some cases where sedation may not be recommended, a local anesthetic may be used. However, retinoblastoma patients are typically under five, so sedation is preferred in most cases.

Samples are then taken, most often from the back of the pelvic bone. For the bone marrow aspiration, a hollow needle is inserted into the bone and a syringe is used to collect a sample of the liquid bone marrow. Once this is done, a bone biopsy is typically performed immediately. For this procedure, a larger needle is inserted into the same area, collecting a section of bone and marrow. The entire procedure often takes no longer than 30 minutes.

Bone Marrow Aspiration and Biopsy Results

The tissue samples will be examined closely by a pathologist that is experienced in detecting retinoblastoma abnormalities. Results usually take about one to two days to receive, but can be rushed if the situation is deemed an emergency. The results are given to the treating physician, who will then review the results with the patient. If retinoblastoma is detected, treatment will be started as soon as possible.

Side Effects of Bone Marrow Aspiration and Biopsy

Bone marrow aspiration and bone marrow biopsies typically do not involve complications, but in rare cases infection and excessive bleeding have occurred. In procedures involving sedation, there is the risk that the patient may have an allergic reaction or breathing difficulties. This risk is increased slightly by the fact that retinoblastoma patients are usually under the age of five, so allergies may not have been determined prior to the procedure.

After the procedure, the child will sometimes feel tenderness and pain in the pelvic area where the samples were taken from. This pain typically subsides within one to two days, but may last longer. The physician will instruct the child’s parents on home care required following a bone marrow aspiration and bone marrow biopsy to prevent infection and speed healing time.