What is a bone marrow test. How is a bone marrow test performed. Why might you need a bone marrow test. What are the types of bone marrow biopsies. How long does a bone marrow test take. What are the potential side effects of a bone marrow test.

Understanding Bone Marrow and Its Importance

Bone marrow is the spongy tissue found inside our bones, responsible for producing blood cells. This vital component of our skeletal system plays a crucial role in maintaining our overall health. But how exactly does bone marrow function, and why is it so important?

The primary function of bone marrow is hematopoiesis – the process of creating new blood cells. These include:

• Red blood cells (erythrocytes) – responsible for carrying oxygen throughout the body
• White blood cells (leukocytes) – crucial for fighting infections and diseases
• Platelets (thrombocytes) – essential for blood clotting

Given its critical role in blood cell production, any abnormalities in the bone marrow can have significant implications for a person’s health. This is where bone marrow tests come into play, providing valuable insights into the functioning of this vital tissue.

The Purpose of Bone Marrow Tests

Bone marrow tests are diagnostic procedures used to examine the health and functioning of bone marrow. These tests can provide crucial information about various health conditions, particularly those affecting blood cell production or the presence of certain cancers.

When might a doctor recommend a bone marrow test? There are several scenarios:

• To diagnose or rule out certain types of blood cancers, such as leukemia, lymphoma, or multiple myeloma
• To evaluate unexplained anemia, low platelet counts, or other blood disorders
• To assess the spread of certain cancers to the bone marrow
• To monitor the effectiveness of cancer treatments
• To investigate persistent fevers of unknown origin

Understanding the reasons behind a bone marrow test can help patients feel more prepared and less anxious about the procedure.

Types of Bone Marrow Tests

There are two main types of bone marrow tests: bone marrow aspiration and bone marrow biopsy. Often, these procedures are performed together to provide a comprehensive assessment of the bone marrow.

Bone Marrow Aspiration

In this procedure, a small amount of liquid bone marrow is drawn out using a hollow needle. The aspiration provides information about the types and maturity of blood cells present in the bone marrow.

Bone Marrow Biopsy

Also known as a trephine biopsy, this procedure involves removing a small core of bone marrow tissue, typically about 1-2 cm long. The biopsy provides information about the overall structure of the bone marrow and how densely packed it is with cells.

How do these two procedures differ in terms of the information they provide? While both tests can reveal valuable information, the bone marrow biopsy gives a more comprehensive view of the bone marrow’s structure and cellularity. The aspiration, on the other hand, allows for a detailed examination of individual cells.

The Bone Marrow Test Procedure: What to Expect

Understanding the bone marrow test procedure can help alleviate anxiety and prepare patients for what to expect. The test typically takes about 30 minutes and is usually performed in an outpatient setting.

Here’s a step-by-step breakdown of the procedure:

1. Preparation: The patient changes into a hospital gown and lies on their side with knees tucked up to their chest.
2. Cleaning: The area where the sample will be taken (usually the hip bone) is cleaned with antiseptic.
3. Anesthesia: A local anesthetic is injected to numb the area.
4. Aspiration: A thin needle is inserted through the skin into the bone. A small amount of liquid bone marrow is drawn out using a syringe.
5. Biopsy: If a biopsy is also being performed, a slightly larger needle is used to remove a small core of bone marrow tissue.
6. Completion: The needles are removed, and pressure is applied to stop any bleeding. A bandage is placed over the site.

During the procedure, patients may feel some pressure or a brief, sharp pain when the needle is inserted or when the marrow is being drawn out. However, the local anesthetic helps minimize discomfort.

Preparing for a Bone Marrow Test

Proper preparation can help ensure a smooth and successful bone marrow test. While specific instructions may vary depending on the healthcare provider, here are some general guidelines:

• Inform your doctor about any medications or supplements you’re taking, especially blood thinners
• Discuss any allergies or medical conditions you have, particularly if you’ve had problems with anesthesia in the past
• Arrange for someone to drive you home after the procedure, especially if you’ll be receiving sedation
• Wear comfortable, loose-fitting clothing to the appointment
• Follow any fasting instructions provided by your healthcare team

Is there anything specific you should avoid before a bone marrow test? It’s generally advisable to avoid taking blood-thinning medications for several days before the procedure, but always consult with your doctor before stopping any prescribed medications.

Potential Risks and Side Effects of Bone Marrow Tests

While bone marrow tests are generally safe procedures, like any medical intervention, they do carry some risks and potential side effects. Being aware of these can help patients know what to expect and when to seek medical attention.

Common side effects of bone marrow tests include:

• Pain or discomfort at the biopsy site, which usually subsides within a few days
• Bruising or swelling at the biopsy site
• Minor bleeding from the biopsy site

Less common, but more serious complications can include:

• Infection at the biopsy site
• Prolonged bleeding, especially in patients with bleeding disorders
• Allergic reactions to the local anesthetic
• In rare cases, damage to nearby tissues or bones

How can patients minimize the risk of complications? Following post-procedure care instructions carefully, keeping the biopsy site clean and dry, and reporting any unusual symptoms to your healthcare provider can help reduce the risk of complications.

Interpreting Bone Marrow Test Results

After a bone marrow test, the samples are sent to a laboratory for analysis. The results typically become available within one to two weeks. But what exactly do these results mean?

Bone marrow test results can provide information about:

• The overall health and structure of the bone marrow
• The types and maturity of blood cells present
• The presence of abnormal cells or cancer cells
• The iron content of the bone marrow
• The effectiveness of treatments for certain blood disorders or cancers

How are the results interpreted? A pathologist examines the samples under a microscope, looking for any abnormalities in cell types, numbers, or maturity. They may also perform additional tests on the samples, such as flow cytometry or genetic testing, to provide more detailed information.

It’s important to note that bone marrow test results should always be interpreted in conjunction with other clinical information and test results. Your healthcare provider will discuss the results with you and explain what they mean for your specific situation.

Living with a Bone Marrow Disorder: Support and Resources

For those diagnosed with a bone marrow disorder based on their test results, coping with the diagnosis and navigating treatment can be challenging. However, numerous support systems and resources are available to help patients and their families.

Some valuable resources for those living with bone marrow disorders include:

• Patient support groups, both in-person and online
• Educational materials from reputable medical organizations
• Counseling services to help cope with the emotional impact of a diagnosis
• Financial assistance programs for medical expenses
• Clinical trial databases for those interested in participating in research

How can patients best advocate for themselves? Being informed about your condition, asking questions, seeking second opinions when necessary, and actively participating in treatment decisions are all important ways to advocate for your health.

Remember, a bone marrow disorder diagnosis doesn’t define you. With proper support and care, many individuals with these conditions lead fulfilling lives and successfully manage their health.

Advances in Bone Marrow Testing and Treatment

The field of hematology and bone marrow research is constantly evolving, with new technologies and treatments emerging regularly. These advancements are improving both the diagnostic accuracy of bone marrow tests and the treatment options available for bone marrow disorders.

Some recent developments in bone marrow testing include:

• Next-generation sequencing techniques, allowing for more detailed genetic analysis of bone marrow samples
• Improved imaging technologies for guided biopsies, increasing accuracy and reducing patient discomfort
• Liquid biopsies, which may provide an alternative to traditional bone marrow biopsies in some cases

In terms of treatment, exciting advances include:

• CAR T-cell therapy for certain types of blood cancers
• Targeted therapies that attack specific genetic mutations in cancer cells
• Improved bone marrow transplant techniques, including haploidentical transplants
• Gene therapy approaches for certain inherited blood disorders

How might these advances impact patient care in the future? As diagnostic techniques become more sophisticated, we may see earlier and more accurate diagnoses of bone marrow disorders. Additionally, more targeted and personalized treatment approaches could lead to improved outcomes and quality of life for patients.

While a bone marrow test may seem daunting, it’s a valuable diagnostic tool that can provide crucial information about your health. By understanding the procedure, its purpose, and what to expect, patients can approach the test with confidence. Remember, knowledge is power when it comes to your health, and a bone marrow test is just one step in the journey towards understanding and managing your overall well-being.

Bone marrow test | Tests and scans

What is a bone marrow test?

A bone marrow test is a way of testing cells from your bone marrow. Bone marrow is the spongy tissue inside your bones that makes blood cells.

Why do I need it?

To find out whether there are any cancer cells in the bone marrow. You might also have one to check whether treatment is working.

How do you have it and how long does it take?

You have a local anaesthetic injection to numb a small area on your hip. The doctor puts a needle into your hip to suck out some bone marrow. The test takes about 30 minutes. You should get your results within 1 or 2 weeks.

Are there any side effects?

Possible side effects can include bruising, bleeding, pain, infection or tingling in the legs.

You have a bone marrow test to check whether there are cancer cells in your bone marrow. Bone marrow is spongy tissue and fluid that is inside your bones. It makes your blood cells. Depending on your cancer type, this test can also check how well your treatment is working. 

A doctor or specialist nurse removes a sample of bone marrow cells or an area of bone marrow in one piece. This is usually from your hip. A specialist doctor can then look at the cells or tissue under a microscope.

You usually have the test in the outpatient department of the hospital. But you may have this on the ward if you are staying overnight in hospital (inpatient).

You’re usually awake for the test. You have a local anaesthetic to numb the area. Some people have medicine to make them drowsy (sedation).

Why might you have a bone marrow test?

Bone marrow tests are usually done for cancers that are most likely to affect the bone marrow, such as:

• lymphomas
• leukaemia’s
• myeloma

But it can be done for any type of cancer. This is usually if your doctor thinks your bone marrow could contain cancer cells, or they need to rule this out for any reason.

Types of biopsy

There are 2 main types of bone marrow test: 

• bone marrow aspiration
• bone marrow trephine biopsy

Aspiration means the doctor or nurse draws some liquid bone marrow up into a syringe.

A bone marrow trephine biopsy means they remove a very thin 1 or 2cm long core of bone marrow in one piece.

You usually have both of these tests done at the same time. They give some of the same information to the doctor, but there are differences. The bone marrow trephine shows the structure of the bone marrow inside the bone, whereas the aspiration takes just the bone marrow cells.

What happens

Your doctor will give you information about the procedure and asks you to sign a consent form. This is a good time to ask any questions you have.

You might need to change into a hospital gown. You can usually keep your underwear on.

You lie on your side with your knees tucked up into your chest.

Your doctor or nurse cleans the area with some antiseptic fluid. This can feel cold.

You’ll then have an injection into the skin over the biopsy site (local anaesthetic) to numb the area. They then put a thin needle through the skin into the hip bone. This might be uncomfortable for some, but this only lasts a short time.

Your doctor or nurse draws a small amount of liquid bone marrow into the needle, using a syringe. You might feel a pulling sensation when they start drawing the bone marrow cells out. 

They take this needle out and put the second one in if you are having a trephine biopsy. The aim is to get a small amount of marrow out in one piece.

The whole test takes around 30 minutes.

Take a look at this 2 minute video about having a bone marrow test. 

Transcript

What to expect when you have a bone marrow test

Your bone marrow is the spongy substance in the centre of the bones where the blood cells are made.

You may have a bone marrow test if you have a cancer which affects the bone marrow such as leukaemia, lymphoma or myeloma. if your doctor thinks your bone marrow may contain cancer cells that have spread from another type of cancer or you have a non-cancerous condition.

There are two types of tests. A bone marrow aspiration which takes some bone marrow cells and a bone marrow biopsy which takes samples of the bone marrow and gives more information about its structure.

Usually your doctor takes the sample from the back of your hip bone but you can have a bone marrow aspiration from your breast bone.

You have the test lying on a couch. You may have a sedative beforehand to make you sleepy. The doctor then injects some local anaesthetic to numb the area.

For a bone marrow aspiration they put a needle through your skin and into your bone. Then using a syringe they draw out some liquid bone marrow. You may feel a pulling sensation as they do this.

For a biopsy your doctor uses a slightly bigger needle to take the sample of bone marrow. They turn and push this needle to get the sample. This can be painful as the needle goes in but it doesn’t last for long.

You usually go home about half an hour after the test. If you had sedation you need to wait until you are fully awake. This can take a few hours.

Afterwards your hip will ache for a few days. Taking painkillers helps.

You may also have some bruising. Rarely you may have some slight bleeding from the site. Press on it if you do and if it doesn’t stop contact the hospital.

There is a small risk of infection. Tell your doctor if you have a temperature or the biopsy area becomes red and sore.

You may have some tingling in your leg which will also wear off with time.

Sedation

Some people prefer to have some type of sedative before the test so that they are a bit drowsy. Some hospitals may use gas and air (Entonox) to help relax you instead of sedation.

Children and teenagers often have sedation for this type of test.

We have a children’s cancer section where you can find out about this test if your child has acute lymphoblastic leukaemia (ALL).  

After your bone marrow test

You usually go home the same day if you’re feeling well enough.

You have a dressing over the site, which you should keep on for 24 hours. If you notice any bleeding apply pressure to the area. If it doesn’t stop, contact the hospital.

After the test, your hip might ache for a couple of days. You may need some mild painkillers such as paracetamol to take at home.

As you’re having sedation you’ll need someone with you so they can take you home and stay with you overnight. Also for 24 hours after you shouldn’t drive, drink alcohol, operate heavy machinery or sign any legally binding documents.

Possible risks from having a bone marrow test

A bone marrow test is very safe and any risks are small. 

During the procedure there is a very small risk of damage to nearby structures, but this is very rare.  

Bleeding

It’s not unusual to have a small amount of bleeding from the area where the needle went in. If you notice any heavy bleeding, apply pressure to the area. If it doesn’t stop, contact the hospital.

Bruising

Sometimes blood leaks out of the vein and collects under your skin. This can look like a small dark swelling under the skin (haematoma). Pressing hard once the needle is removed can help.

Infection

There is a small risk of getting an infection in the wound. Tell your doctor if you have a temperature or if the area becomes red and sore. 

Pain

Some people feel uncomfortable and have pain after the local anaesthetic has worn off. Your nurse will tell you what painkillers to take. If you have severe pain or it’s getting worse then you should contact the hospital.

Tingling in your leg

You may have some tingling in your leg which wears off with time.

Getting your results

Your bone marrow test is looked at in the laboratory. The time it takes to receive results depends on the which tests are being done on the bone marrow samples.

Basic results can be available as soon as 24 to 48 hours. Whereas if for example you’re having genetic tests on your bone marrow samples, these results can take a couple of weeks. You won’t get any results at the time of having a bone marrow taken. It’s best to ask your doctor or nurse how long it will take to get them.

Waiting for test results can make you anxious. You might have the contact details of a specialist nurse. You can contact them for information and support if you need to. It may also help to talk to a close friend or relative about how you feel. 

For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

More information

We have more information on tests, treatment and support if you have been diagnosed with cancer.

• Hoffbrand’s Essential Haematology (8th Edition)
  AV Hoffbrand and D P Steensma
  Wiley Blackwell, 2019

• The Royal Marsden Manuel of Clinical Nursing Procedures, Professional Edition (10th Edition)
  S Lister, J Hofland and H Grafton
  Wiley Blackwell, June 2020

• Tissue pathways for lymph node, spleen and bone marrow trephine biopsy specimens
  The Royal College of Pathologists, November 2017

• ICSH guidelines for the standardization of bone marrow immunohistochemistry
  E E Torlakovic and others
  International Journal Of Laboratory Hematology, 2015. Volume 37, Pages 431 to 449

• European recommendations and quality assurance for cytogenomic analysis of haematological neoplasms
  KA Rock and others
  Leukaemia, 2019. Volume 33, Issue 19, Pages 1851 to 1867

• The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact [email protected] with details of the particular issue you are interested in if you need additional references for this information. 

Last reviewed: 

26 Jul 2022

Next review due: 

26 Jul 2025

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Bone Marrow Biopsy | Johns Hopkins Medicine

What is a bone marrow biopsy?

A bone marrow biopsy involves removing a small sample of the bone marrow
inside your bones for testing. Bone marrow is a soft tissue in the center
of most large bones. It makes most of the body’s blood cells.

The biopsy is done using a small needle inserted into the bone. The bone
marrow tissue is removed and then sent to a lab and checked under a
microscope. You may be given a shot (injection) of a local anesthetic
before the biopsy. This will numb the area so you don’t feel any pain.

Why might I need a bone marrow biopsy?

A bone marrow biopsy is usually done if your healthcare provider thinks
that you have a problem making blood cells. A specialist called a
pathologist examines blood and bone marrow samples in a lab. The
pathologist can check your bone marrow for any of the following:

• Unexplained anemia (lack of red blood cells)

• Abnormal numbers of blood cells (red blood cells, white blood
  cells, or platelets)

• Lack of iron (iron deficiency)

• Cancers of the blood-forming tissue (leukemia or lymphoma)

• Cancers that have spread to the bone marrow

• Response to chemotherapy

There may be other reasons for your healthcare provider to recommend a bone
marrow biopsy.

What are the risks of a bone marrow biopsy?

As with any procedure, problems can occur. Some possible complications may
include:

• Bruising and discomfort at the biopsy site

• Prolonged bleeding from the biopsy site

• Infection near the biopsy site

You may have other risks that are unique to you. Be sure to discuss any
concerns with your healthcare provider before the procedure.

How do I get ready for a bone marrow biopsy?

• Your healthcare provider will explain the procedure to you. Ask him
  or her any questions you have.

• You may be asked to sign a consent form that gives permission for
  the procedure. Read the form carefully and ask questions if
  anything is not clear.

• Tell your provider if you are pregnant or think you may be
  pregnant.

• Tell your provider if you are sensitive to or are allergic to any
  medicines, latex, tape, and anesthesia medicines (local and
  general).

• Tell your provider about all the medicines you take. This includes
  both over-the-counter and prescription medicines. It also includes
  vitamins, herbs, and other supplements.

• Tell your provider if you have a history of bleeding disorders. Let
  your provider know if you are taking any blood-thinning medicines,
  aspirin, ibuprofen, or other medicines that affect blood clotting.
  You may need to stop taking these medicines before the procedure.

• You may be asked not to eat for several hours before to the
  procedure. This often means no food or drink after midnight.

• You may receive a medicine (a sedative) to help you relax before
  the biopsy. The sedative may make you drowsy. So you will need to
  have someone drive you home.

Your healthcare provider may have other instructions for you based on your
medical condition.

What happens during a bone marrow biopsy?

A bone marrow biopsy may be done on an outpatient basis. This means you go
home the same day. Or you may stay in a hospital. Procedures may vary
depending on your condition and your provider’s practices.

A bone marrow biopsy is often done using a pelvic bone, but another bone
(such as the breastbone) may be used. In a child, a leg bone or a bone in
the spine (vertebra) may be used.

Generally, a bone marrow biopsy follows this process:

1. You will be asked to remove clothing and may be given a gown to
   wear.

2. Your position may vary depending on the bone that is used. You may
   be asked to lie on your side or your stomach if the pelvis bone is
   used.

3. During the procedure, you will need to lie as still as possible.

4. The skin over the biopsy site will be cleaned with a sterile
   (antiseptic) solution.

5. You will feel a needle stick and a brief sting as the provider
   injects a local anesthetic to numb the area.

6. A small cut (incision) may be made over the biopsy site. The biopsy
   needle will be inserted through the bone and into the bone marrow.

7. A bone marrow aspiration is usually done first. The provider will
   use a syringe to pull a small liquid sample of the bone marrow
   cells through the needle. It is common to feel pressure as the
   needle is pressed into your bone. You will have a pulling feeling
   when the marrow is removed.

8. The provider will remove a small, solid piece of bone marrow using
   a special hollow needle. This is called a core biopsy.

9. The biopsy needle will be removed. Firm pressure will be applied to
   the biopsy site for a few minutes, until the bleeding has stopped.

10. A sterile bandage or dressing will be applied.

11. The bone marrow samples will be sent to the lab for exam.

What happens after a bone marrow biopsy?

Once you are home, it is important to keep the biopsy area clean and dry.
Your healthcare provider will give you specific bathing instructions. Leave
the bandage in place for as long as directed by your provider. This is
often until the next day.

Take a pain reliever as recommended by your provider. Aspirin or other pain
medicines may raise your risk of bleeding. Be sure to take only medicines
your healthcare provider has approved.

Call your provider if you have any of the following:

• Fever

• Redness, swelling, bleeding, or other drainage from the biopsy site

• More pain around the biopsy site

You may go back to your usual diet and activities unless your healthcare
provider advises you differently.

Your healthcare provider may give you other instructions, depending on your
situation.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s
  qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or
  problems

• How much will you have to pay for the test or procedure

Bone marrow cancer – symptoms, treatments, prevention and diagnosis

The bone marrow is considered a special organ in the human body responsible for creating new blood cells that replace already dead cells. Factors of the internal environment can influence these cells, as a result of which they can develop in different directions.

Experts believe that bone marrow cancer is an incorrect name for the disease. However, it is this term that describes all diseases that are characterized by the growth of a malignant tumor in the cells of the bone marrow.

Among these diseases are:

• melanoma. Melanoma is a malignant tumor that begins its growth in plasma cells;
• leukemia. This disease, namely neoplasms that appear in the hematopoietic system, are the most common malignant problems of the bone marrow;
• lymphomas. Lymphomas arise in the lymphatic tissue and are malignant neoplasms. Lymphomas first affect the lymph nodes, but in rare cases they can begin to manifest themselves immediately in the tissues of the bone marrow. Usually, a malignant tumor begins to affect the bone marrow only at the beginning of the fourth stage of the disease.

Causes

The most common cause of bone marrow cancer is a mutation in stem cells. In fact, mutations in the human body occur regularly, but there are special mechanisms that can correct errors or kill mutated cells.

When a person begins to develop oncology, in particular cancer of the bone marrow, these mechanisms cease to work, as the cells mutate in large numbers, as a result of which the body ceases to perceive them as foreign. Ultimately, cancer cells crowd out healthy, unmutated cells. For the development of cancer, mutations are necessary in previously mutated cells or malfunctions in the immune system of the human body, since various pathologies can occur due to this.

Who can get bone marrow cancer?

There are quite a few risk groups for those who can get bone marrow cancer. These are persons whose closest relatives suffered from a form of bone marrow cancer. Also people who have immunodeficiency.

Some people have diseases that are called predisposed to bone marrow cancer, including monoclonal gammopathy, as well as mononucleosis. Patients who take drug therapy aimed at fighting the tumor are also at risk of developing bone marrow cancer.

Symptoms and signs of bone marrow cancer

If a person has myeloma, they will experience bone pain. Most often, such pain does not appear in one place. They migrate. Also, pain is usually felt during movement. As time goes by, the pain will get worse, eventually it can become unbearable. There is a chance that the patient will remain immobilized.

Also, one of the signs of myeloma is the melting of bone tissue, that is, the level of calcium in the human body will be greatly exceeded, the person will constantly feel nausea, consciousness will be disturbed. In the most severe cases, the patient may fall into a coma.

Kidney damage, blurred vision and frequent bleeding are also signs of the oncology of the bone marrow in the human body, namely, myeloma.

Myeloma damages the roots of the spinal nerves, resulting in limb numbness and paralysis.

Symptoms of leukemia are not so pronounced. With leukemia, tumor cells begin to crowd out healthy sprouts of bleeding, as a result, a person begins to suffer from anemia, constant bleeding and immunodeficiency. If a person develops neuroleukemia, then he feels constant headaches, nausea, vomiting.

Diagnosis of bone marrow cancer in the cancer center

In order to detect bone marrow cancer, a comprehensive approach to examination is required. The person is given a history and a physical examination. In this case, the specialist should learn about all the complaints and symptoms that the patient himself feels. The patient is then sent for examination. Myeloma may be suspected after a bone x-ray. Leukemia can be detected by doing a complete blood count.

Diagnosis confirmation

In order to accurately say whether a person has bone marrow oncology, it is necessary to conduct a morphological study of the tumor substrate. To do this, the patient must undergo a puncture or biopsy of the bone marrow.

Oncology center specialists also conduct tests that will clarify the molecular genetic profile of cancer.

All these studies are necessary in order to choose the most accurate and most effective tactics for treating the patient. In addition, the data of analyzes and tests will help to choose the optimal method of chemotherapy.

Where can I get tested?

You can get an examination at the Cancer Center Sofia: 2nd Tverskoy-Yamskoy pereulok, 10. Our specialists are ready to examine all patients with professionalism and accuracy, as well as to begin treatment in case of a disease.

Bone marrow cancer treatment

In most cases, bone marrow cancer cannot be completely cured. You can only slow down its development and prolong the patient’s life, since this disease is systemic, and the tumor mass with blood spreads throughout the body.

It should be noted that in bone marrow oncology there is a huge amount of tumor mass in the human body. If we are talking about a radical treatment of a disease, then we will have to act on the body systemically, which is impossible without immunotherapy, chemotherapy and targeted therapy.

The treatment regimen is determined by doctors depending on the type of cancer.

Leukemia treatment system

When leukemia is diagnosed, remission induction is first performed, that is, the person is treated with chemotherapy, since the goal is to destroy as many cancer cells as possible. The human body is experiencing serious negative effects of tumor decay products and chemotherapy components. This shows a lot of side effects.

Consolidation therapy is the second stage of treatment. With the help of chemotherapy, it is impossible to get rid of all brain cancer cells, since some of them are dormant in the early stages, that is, these cells wake up later and begin to activate the re-growth of the tumor, so such therapy is simply necessary.

Reinduction of remission is an exact copy of induction therapy, at this stage the destruction of cells continues. The last step is maintenance therapy, which is designed to destroy the remaining malignant cells.

Chemotherapy

Chemotherapy is most often used in combination with radiation therapy. At the same time, the patient must take hormonal drugs to improve the condition of the blood and the whole body, since chemotherapy has a strong effect on the body.

A person’s hair may fall out and their health may deteriorate dramatically. Also, doctors prescribe the use of drugs that are designed to fight the destruction of bone tissue in the body. Membrane plasmapheresis is a procedure that I prescribe in order to prolong the life of the patient.

Surgical treatment

In surgery, which is the most effective treatment for bone marrow cancer, specialists perform a bone marrow transplant. This procedure is complicated by the fact that it is extremely difficult to find a donor for transplantation, since the body can reject the new bone marrow.

This procedure is also quite expensive. Most often, the closest relatives are suitable as donors. Surgical intervention is refused when the patient is in serious condition or the organs are affected by distant metastases.

Predictions

The prognosis of human survival in bone marrow cancer depends on the type of tumor. With acute leukemia, a person can live without a relapse for five years in 80% of cases. The longer the remission lasts, the greater the likelihood of complete remission of the disease, however, with bone marrow cancer, in most cases, a relapse occurs, that is, the patient needs repeated treatment.

Some patients experience multiple relapses. In each case, returning to a state of remission becomes increasingly difficult. However, there have been cases where people recovered even after several relapses.

Myeloma is an incurable disease. Even after a bone marrow transplant within 3-5 years, bone marrow cancer can return. Chronic leukemia is practically not amenable to treatment, they occur with exacerbations and attenuation. Most often, this disease occurs in people whose age is approaching the elderly. In this case, intensive treatment is contraindicated, it remains only to carry out maintenance therapy.

Complications

With the rapid development of bone marrow cancer, healthy cells are replaced by cancer cells at an incredibly fast rate. Blood formation is greatly slowed down, a person suffers from anemia, bleeding and immunodeficiency. Myeloma and leukemia are characterized by severe pain, which can only be relieved with the use of narcotic analgesics.

Relapse

The type of bone marrow cancer determines the likelihood of recurrence. Some forms of leukemia are treatable, that is, a person has the opportunity for a full recovery. Chronic forms of cancer are practically incurable, myeloma is also considered incurable. If standard therapy is used, then relapse should occur after about 29 months. If a tandem transplant has occurred, then the patient can stay in remission for more than 40 months.

How to make an appointment with a specialist at Sofia Cancer Center?

You can make an appointment with the specialists of the Sofia Cancer Center by calling +7(495)995-00-33 or using the form on the website. Address: 10, 2nd Tverskoy-Yamskoy lane. After receiving the results, doctors will determine the extent of the spread of cancer and prescribe the best treatment option. Note that our specialists take into account not only the type of disease, but also the individual characteristics of the human body.

Bone marrow cancer: symptoms and manifestations in an adult, how long they live, treatment of a bone marrow tumor

The bone marrow is a special organ whose main function is hematopoiesis – the creation of new blood cells instead of dying ones. It is located inside the lamellar and spongy bones. In adults, the bone marrow contains the largest number of undifferentiated (immature) cells (stem). Under the influence of internal environmental factors, they can develop into any germ of hematopoiesis (hematopoiesis).

The term “bone marrow cancer” is incorrect. However, under it, patients, as a rule, understand a malignant tumor that grows from bone marrow cells. So what is the name of bone marrow cancer right? This is a whole group of diseases, each has its own name:

• Myeloma is a malignant tumor that grows from plasma cells (differentiated B-lymphocytes).
• Leukemias are malignant neoplasms of the hematopoietic system. This is the most extensive and frequently detected group of diseases of this localization.
• Lymphomas are malignant tumors of the lymphatic tissue. Usually, lymphomas debut with the defeat of the lymph nodes, but there are rare cases when the primary foci are found immediately in the bone marrow. Basically, it is affected in stage 4 lymphoma, when the tumor leaves the lymphatic system and begins to spread to extralymphatic organs and tissues.

Causes of bone marrow cancer

The most common causes of so-called bone marrow cancer are mutations in hematopoietic stem cells. It should be noted that mutations in the human body occur every second, but normally there are many mechanisms that correct errors or destroy damaged cells. In cancer, these mechanisms are disrupted and malignantly transformed cells begin to actively divide, colonizing the bone marrow and crowding out healthy cells.

In order for cancer to develop, special circumstances are needed, for example, repeated mutations in already mutated cells, or violations of the immune defense, which does not recognize the pathology in time and skips it.

Who is at risk

• Persons whose immediate blood relatives have had myeloma, leukemia or lymphoma
• Patients with primary and secondary immunodeficiencies.
• Persons exposed to ionizing radiation (undergoing radiation therapy, liquidators of the consequences of the Chernobyl disaster) or chemical carcinogens.
• Persons who have taken or are taking anticancer drug therapy.
• Presence of predisposing diseases — mononucleosis, monoclonal gammopathy.

Symptoms of bone marrow cancer

Symptoms of bone marrow cancer are determined by the type of tumor and its pathogenesis. For example, myeloma is characterized by pain in the bones. At first, they are migratory in nature and intensify with movement. Over time, the symptoms increase, the pain becomes unbearable and can even completely immobilize the patient.

In addition, in case of bone marrow cancer, symptoms can manifest as follows:

1. Due to the melting of bone tissue, the level of calcium in the blood rises, which leads to the development of symptoms of intoxication, nausea and vomiting, impaired consciousness up to coma.
2. Kidney damage.
3. Blood hyperviscosity syndrome: bleeding, impaired vision and consciousness.
4. Neurological signs of bone marrow cancer: paresis, paralysis, numbness, pain. Develop with damage to the vertebrae and compression of the roots of the spinal nerves.

Symptoms may vary for different bone marrow cancers. Manifestations of leukemia are mainly associated with the displacement of normal hematopoietic sprouts by tumor cells, which leads to the development of anemia, severe immunodeficiencies and bleeding. With the development of neuroleukemia, meningeal symptoms are observed: headache, nausea and vomiting, stiff neck. In the advanced stages of bone marrow cancer, signs include enlarged lymph nodes, spleen, and liver.

Diagnosis

The diagnosis of bone marrow cancer requires a comprehensive approach. The first point is the collection of an anamnesis with an assessment of existing complaints and a physical examination. Next, the patient is sent for examination. Myeloma can be suspected on the basis of a bone x-ray, leukemia – on a general blood test.

To confirm the diagnosis of a bone marrow tumor, a morphological examination of the tumor substrate is required. For this purpose, a biopsy or puncture of the bone marrow is performed. In addition, additional tests are carried out to clarify the molecular genetic profile of cancer. This is necessary to determine the tactics of treatment and select the optimal method of chemotherapy.

Treatment

In the vast majority of cases, so-called bone marrow cancer is a systemic disease with a large tumor mass spread throughout the body. Therefore, radical treatment requires a systemic effect on the body, which is achieved with the help of chemotherapy, immunotherapy and targeted therapy.

The treatment regimen will be determined by the type of cancer. For example, in leukemia, therapy is carried out in several stages:

1. Remission induction. At this stage, the goal is to destroy as many cancer cells as possible, so powerful multicomponent chemotherapy regimens are used. At the same time, the body has a toxic effect from two sides – the direct effect of chemotherapeutic drugs plus the effect of tumor decay products.
2. Consolidation of remission. Induction drugs, no matter how powerful they are, cannot destroy all cancer cells in one course, because some of them are in an inactive state and “wake up” after some time, giving the second onset of a tumor. To destroy them, consolidation therapy is carried out.
3. Reinduction of remission. This is a repetition of the course of induction therapy in order to completely destroy the remaining cancer cells.
4. Maintenance therapy. This is the last step. Its goal is to destroy the remaining malignant cells. For this, long courses of cytostatic drugs in low doses are prescribed.

In highly malignant forms of bone marrow cancer (myelomas, aggressive forms of leukemia, relapses of the disease), a powerful high-dose chemotherapy is carried out, which allows to overcome the resistance of the tumor. However, it has a powerful destructive effect on the bone marrow, leaving the patient virtually without hematopoiesis. To overcome this complication, hematopoietic stem cell transplantation is performed, which will subsequently serve as the basis for the restoration of hematopoiesis.

Stem cells can be taken from the patient at the stage of consolidation of remission, or from a donor. In the latter case, a new clone of leukocytes will have an antitumor effect on possible remaining cancer cells. Thus, the therapeutic effect will be enhanced. However, allogeneic transplants can lead to the development of such a formidable complication as graft-versus-host disease, which in severe cases can lead to the death of the recipient.

Allogeneic transplantation is not indicated for all patients. They are recommended, for example, in the treatment of myeloma. Some of these patients are eligible for double or tandem transplantation, in which two stem cell transplants are performed.

Features of the disease in pregnant women and the elderly

Bone marrow cancer is more unfavorable in the elderly. This is due to the presence of concomitant pathology and the presence of restrictions in the use of high-dose chemotherapy, which could potentially lead to a stable remission. For example, in myeloma patients over 65 years of age, double stem cell transplantation is not performed due to the high risks of mortality.

For pregnancy, it is recommended to use reliable contraception for at least 2 years after achieving remission. If the disease was first diagnosed during pregnancy, then the tactics are chosen individually, taking into account the gestational age and type of tumor. Patients in the first trimester of pregnancy are advised to interrupt and immediately start chemotherapy. With sluggish forms of leukemia, expectant management is possible. Starting from the second trimester of pregnancy, there is the possibility of chemotherapy treatment with drugs that do not adversely affect the fetus. A few weeks before delivery, therapy is suspended so that the bone marrow has time to recover. The method of delivery is chosen based on the obstetric situation.

If bone marrow cancer is diagnosed at the end of the third trimester, early delivery is possible followed by a full course of chemotherapy.

Complications

With the progression of the disease and the ineffectiveness of therapy, the bone marrow is completely replaced by cancer cells. This radically inhibits hematopoiesis and leads to severe anemia, immunodeficiencies, thrombocytopenia with bleeding. Also, for many types of leukemia and myeloma, an increase in pain syndrome is characteristic, which requires the use of narcotic analgesics.

Relapse

The likelihood of recurrence depends on the type of cancer. For example, most forms of acute leukemia respond well to therapy and offer a high chance of a complete cure. Chronic leukemias are prone to a slow course, but are very difficult to cure. Myeloma is also one of the incurable forms of bone marrow cancer. The time to recurrence with standard therapy is about 29 months, and with tandem transplantation – about 42 months.

With the development of relapse, the treatment tactics are determined depending on the period of relapse-free survival. Generally, if more than 6-12 months have passed, first-line chemotherapy regimens can be used. At shorter periods, the tactics are changed and drugs of the second and subsequent lines of therapy are prescribed, to which the cancer has not yet developed resistance.

Prognosis and prevention of bone marrow cancer

The prognosis for bone marrow cancer depends on the type of tumor. For example, in acute leukemia, the five-year relapse-free survival ranges from 80%. At the same time, the more time has passed since the onset of remission, the more likely it is that the disease has completely receded. But at any time, a relapse can develop – a return of the disease, which will require repeated treatment. In some patients, there may be several such relapses, and it is more difficult to achieve remission each time, but this does not mean that it is impossible. In some patients, even after several relapses, recovery can be achieved.

As for chronic leukemias, they are very difficult to cure, but they last for a long time with periods of exacerbation and attenuation. Considering that in most cases they develop in older people, radical treatment may be contraindicated due to the presence of concomitant pathology. In these cases, supportive therapy is prescribed.