During a Bone marrow biopsy samples of bone marrow are taken and examined for signs of abnormal B-cells. This is the only definitive way to diagnose Waldenstrom’s macroglobulinaemia.
Bone marrow is the spongy tissue found in the middle of the bigger bones in your body. This is where blood cells are made.
A bone marrow biopsy is a procedure where a small sample of your bone marrow is taken for testing, to check for abnormal cells. This test is the only one that can diagnose Waldenstrom’s macroglobulinaemia, because WM is a cancer of the bone marrow.
What are they looking for?
The sample from your bone marrow will be sent to a haematopathologist, who is an expert in examining blood and bone marrow samples. They will look for the abnormal white blood cells that cause WM – the lymphoplasmacytic lymphoma cells (LPL cells).
What happens during a bone marrow biopsy?
A bone marrow biopsy takes around twenty minutes, and most people will go to hospital for the procedure and come out on the same day.
Your medical team should give you information about the procedure before you have the biopsy. This should include information about any medication you might need to stop or take (such as blood thinners), and any other preparations. Remember to tell them about any medication or supplements you’re taking before the procedure, in case these change how you need to prepare.
A bone marrow biopsy is usually taken from the back of your hip bone (pelvis). Your doctor or nurse will help you into position beforehand, and make sure that you are comfortable as you’ll need to stay as still as possible for the procedure.
The skin where your biopsy will be taken is cleaned and then the doctor or nurse will inject local anaesthetic into the area. You might feel a sting from the needle, but after a short while the area will go numb.
The cells from your bone marrow are taken through a needle. When the area is numb, the doctor or nurse will put the needle into your bone. They may do this by a manual needle or they may use a battery powered needle that looks like a small drill. Once the needle is in position, a syringe is attached.
The doctor or nurse uses the syringe to pull out a small sample of your bone marrow, which is liquid, called a bone marrow ‘aspirate’. Some people feel a pulling sensation at this point, which can be uncomfortable. This feeling will quickly pass, though.
A sample of the harder bone marrow tissue, called a bone marrow ‘trephine’ is usually taken next. This will done immediately after they’ve take out the bone marrow fluid. They will rotate the needle a few times to take a sample of this harder tissue. Many people describe the sensation as a pushing one, and there may be some pain, but it is usually over very quickly.
After the procedure, your nurse or doctor will ensure that there isn’t any bleeding, before applying a small dressing to the site. You won’t need stitches.
You may experience aching and bruising around the area where the needle went in for a few days after the test.
