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Bone Marrow Biopsy- Myeloma Diagnostics

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A bone marrow biopsy is the diagnostic test for myeloma patients that can hurt. The first time I had a BMB the procedure hurt but only for millisecond. Not even for one second. I didn’t even have time to make a noise.

And, most important, diagnostic testing and staging is central to your life as a MM survivor. 

Multiple Myeloma (MM) occurs when plasma cells in their bone marrow grow uncontrollably. The name of the diagnostic test to determine the percentage of plasma cells in your bone marrow is a bone marrow biopsy or bone marrow aspirate.

In bone marrow aspiration, the back of the pelvic bone is numbed with local anesthetic. Then, a needle is inserted into the bone, and a syringe is used to remove a small amount of liquid bone marrow. This causes a brief sharp pain.

For the biopsy, a needle is used to remove a tiny splinter of bone and marrow. Patients may feel some pressure during the biopsy. There is some soreness in the biopsy area when the numbing medicine wears off. Most patients can go home immediately after the procedure.

The bone marrow tissue is examined in the lab to see the appearance, size, and shape of the cells, how the cells are arranged and to determine if there are myeloma cells in the bone marrow and, if so, how many. The aspirate (the liquid part of the bone marrow) may also be sent for other tests, including immunohistochemistry and flow cytometry, and chromosome analyses, including karyotype and fluorescent in situ hybridization (also known as FISH).

What are the risks and benefits of a bone marrow biopsy?


  1. Diagnostic Accuracy: A bone marrow biopsy is a valuable diagnostic tool that allows healthcare professionals to obtain a direct sample of bone marrow for examination. This can help in diagnosing various conditions, including multiple myeloma.
  2. Treatment Planning: The information obtained from a bone marrow biopsy is crucial for determining an appropriate treatment plan. It helps healthcare providers tailor treatment to the specific condition and characteristics of the patient’s bone marrow.
  3. Monitoring Disease Progression: For individuals undergoing treatment for certain conditions, regular bone marrow biopsies may be performed to monitor the effectiveness of the treatment and the progression of the disease.
  4. Research and Clinical Trials: Bone marrow biopsies play a role in advancing medical knowledge and treatment options by providing researchers with valuable samples for study. Participation in clinical trials may be facilitated by undergoing a bone marrow biopsy.


  1. Pain and Discomfort: The procedure involves the insertion of a needle into the bone, which can cause pain and discomfort. Local anesthesia is typically used to minimize this, but some individuals may still experience discomfort.
  2. Bleeding: There is a risk of bleeding at the biopsy site. However, this risk is generally low, and healthcare providers take precautions to minimize it.
  3. Infection: Although rare, there is a risk of infection at the biopsy site. Strict sterile techniques are employed to reduce this risk.
  4. Bruising: Some individuals may experience bruising at the biopsy site. This is usually temporary and resolves on its own.
  5. Rare Complications: While rare, more serious complications such as damage to nearby structures, nerve injury, or an allergic reaction to anesthesia may occur. The overall incidence of these complications is low.

I am non-secretory. Meaning, my MM didn’t really show much on my blood and urine testing. So my bone marrow biopsy was a really important test to tract the progression of my MM.

Have you been diagnosed with multiple myeloma? What symptoms are you experiencing? At what stage were you diagnosed? Let me know- David.PeopleBeatingCancer@gmail.com


David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

What Is a Bone Marrow Biopsy?

A bone marrow biopsy can take about 60 minutes. Bone marrow is the spongy tissue inside your bones. It’s home to blood vessels and stem cells that help produce:

There are two types of marrow: red and yellow. Red marrow is mainly found in your flat bones such as your hip and vertebrae. As you age, more of your marrow becomes yellow due to an increase in fat cells. Your doctor will extract red marrow, usually from the back of your hip bone. And the sample will be used to check for any blood cell abnormalities…

How to prepare for a bone marrow biopsy

Discussing your concerns is one of the first steps of getting ready for a bone marrow biopsy. You should tell your doctor about all of the following:

  • any medications or supplements you are taking
  • your medical history, especially if you have a history of bleeding disorders
  • any allergies or sensitivities to tape, anesthesia, or other substances
  • if you’re pregnant or think you might be
  • if you have extra anxiety about having the procedure and need medication to help you relax

What do your biopsy results mean?

A primary purpose of the biopsy is to find out whether your bone marrow is functioning properly, and if not to determine why. Your sample will be examined by a pathologist who will perform several tests to help determine the cause of any abnormalities…

Abnormal results may be due to cancer, infection, or another bone marrow disease. Your doctor may need to order more tests to confirm a diagnosis. And they will discuss the results and treatment options if needed and plan your next steps during the follow-up appointment…”



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