Failed bone marrow biopsy

[Marg56]

Had bone marrow biopsy by very experienced Dr. To stage lymphoma. However, after multiple attempts to get aspirate then multiple attempts to get bone sample he was unable to get either. What little was on the needle says hypocellular unable to use for staging. Should I be prepared for bad news?

[lankisterguy Volunteer]

Hi Marg56,

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I will be interested in the replies from our medically trained members, but the engineer here would expect that to be a physical phenomena not indicating a medical problem.

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(I often get the comment that the outer layer of my hip bone is extremely hard, and resists penetration by the cutter. It takes a really determined and confident practicioner to get a good sample. My world class CLL expert doctor admits that he does not do enough BMBs to be good at it, in his clinic there is usually a PA or NP that has the tool skills and practice to punch through to get a sample- it is not always a pleasant experience)

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Len

[Marg56 in reply to lankisterguy]

Thank you for your reply. This was done by interventions radiologist under CT guidance who has performed thousands of BMB. He even drilled a bit deeper after first inability to remove any BM aspirate so that's what worries me. I don't want to go through it again because what would make a second procedure produce any different results is my thought but I know they need it to determine best treatment. Ugh not a happy camper

[lankisterguy Volunteer in reply to Marg56]

I am not medically trained, but I'm not familiar with the need for a BMB to narrow the diagnosis and treatment of a Lymphoma. Most are categorized by FLOW cytometry from the blood, and those that need further differential diagnosis are done from an excised lymph node.

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Staging is often ignored since it is not required for treatment decisions in CLL.

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And for CLL patients, BMBs are rarely used except when the doctors are trying to differentiate AIHA, ITP and other suspected auto immune issues where Red Blood cells or platelets are abnormally low.

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Do you have a CLL diagnosis? Is there another medical condition that the BMB is needed to diagnose?

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Len

[Marg56 in reply to lankisterguy]

I have follicular cell lymphoma that has been confirmed by skin biopsies. Have had CT scans and MRI. No enlarged lymph nodes found.

[lankisterguy Volunteer in reply to Marg56]

Hi Marg56,

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Since our group is focused on Chronic Lyphocytic Leukemia / Small Lymphocytic Lymphoma, and you have not filled in your profile (see item # 3 on this Pinned Post. healthunlocked.com/cllsuppo... )

The answers you will get here likely assume you have CLL/SLL

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There are other groups that may be more useful:

healthunlocked.com/non-hodg...

healthunlocked.com/lymphomaca

healthunlocked.com/leukaemi... for UK

communityview.lls.org/group... for USA

lymphoma.org/aboutlymphoma/... for USA

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Len

[Marg56 in reply to lankisterguy]

Thanks so much, I have switched over to that site. Appreciate your time.

[lankisterguy Volunteer in reply to Marg56]

Glad to help, I hope you can find some answers. Len

[Hidden in reply to Marg56]

I can sympathise as I had a similar experience and have no wish to go through it again. It took nearly an hour and many attempts before they got enough for their purposes.I had, and have always had, a low red cell count so maybe that was why it was considered to be necessary.