Bone marrow biopsy or aspiration?

[paula_dae]

Hi All,

We went today to do the bone marrow biopsy, but they didnt have the needed needle and did only the aspiration. Is this fatal and which markers we will have missing?

Im very surprised since this is the best local hospital with huge oncology department.

Unfortunately, thats the reality. I wouldnt want to put mom through the experience again so I hope the aspiration only is enough, which our doctor confirmed. Is it? Any extra info on that?

[Cllcanada Top Poster CURE Hero]

Bone marrow is preferred, but I have never had one in 20 years. Clinically they are falling out of use a bit in countries outside the U.S. , but there are situations where they are absolutely required.

Aspirations are OK in CLL or SLL but a punch biopsy are prefered in most lymphomas, since more cells are captured.

You will need to wait for the pathology report.

~chris

[Jm954 Administrator]

Hi Paula,

Bone marrow biopsy and aspirate are still commonplace in the UK. If they do a bone marrow biopsy they will always do an aspirate as well but it’s also common to have an aspirate and no biopsy although I realise this wasn’t the original plan for your mom.

The bone marrow biopsy is a solid core of bone marrow taken from the bone and the aspirate is the liquid marrow which is aspirated or sucked out of the marrow space. This liquid marrow is then spread of glass slides, stained and examined under the microscope.

They both show all the type of cells present and their relative numbers. The biopsy has the advantage of showing the architecture of the bone marrow and if the CLL infiltration is diffuse or nodular. It also gives a better idea of cellularity, how much is cells and how much is fat.

I would say that they will almost certainly get all the information they need from the aspirate so please don’t worry about it.

Jackie

[paula_dae in reply to Jm954]

Thank you!

[Jph02006 in reply to Jm954]

Can you point me to a discussion of the architecture features you mention (diffuse vs modular, and cellularity). I recall my BMB results mentioning those, but never got a good explanation of what they mean for CLL

Thanks

John

[Jm954 Administrator in reply to Jph02006]

Here are a couple of old papers that describe the patterns (architecture) and show some pictures. The CLL Society information describes the different types better than the papers.

onlinelibrary.wiley.com/doi...

bloodjournal.org/content/bl...

cllsociety.org/2017/01/basi...

Come back to me if anything isn't clear

Jackie

[Jph02006 in reply to Jm954]

Thank you

[W00dfin]

My aspiration didn’t produce enough material for the sample to be tested. So I had to have a biopsy. Better luck for you and yours!