Bone marrow test

I have been anemic and have had two iron infusions. In s few days, I will be having a bone marrow extraction. I'm a bit nervous about it. What can this test reveal?

[LotteM]

That sounds serious. Didn't you doctor explain why the bone marrow gets extracted and what they will test on it? If you forgot, simply contact them and ask to it be explained again to the point that you understand. Sorry to not be able to be of more help. But this is not a standard procedure and definitely not for RLS. I hope you get things cleared up before the procedure.

[Hidden in reply to LotteM]

Thanks for your input. This all started out to be related to RLS. We were hoping that iron infusions would improve the RLS and raise my hemoglobin. The results weren't satisfactory to my hematologist, and he ordered what he called a bone marrow test. I think it's only a liquid test, done by a needle. He said it wouldn't be that bad and it only takes a minute. Maybe what he discovers will show a way to alleviate the RLS, besides explaining why I'm anemic.

[LotteM in reply to Hidden]

There has been some research into how blood iron relates to spinal fluid iron, brain fluid iron and iron in several parts of the brain. What remained with me is that levels alternated, kind of like a stepwise ascent. I doubt the spinal tap will provide helpful information. Let your doctor read the 2018 iron for RLS recommendations: sciencedirect.com/science/a...

Also, another member recently posted this paper, that says that iron saturation is a somewhat better indicator of whether an iron infusion will result in less RLS symptoms: sciencedirect.com/science/a...

But still, chance of a positive response increases from 50% to 75% (only) with lower percentage saturation. How it works with the iron for RLS is still far from understood.

[cicek]

I have had a bone marrow extraction but definitely not for RLS. Mine was taken due to a problem I have with my blood being too thick. (Polythysemia). It was explained to me very clearly by the doctor was it was for. I am in the UK.

[Elffindoe]

I'm assuming you have iron deficiency anaemia (IDA).

This relates to Red Blood Cells, the cells that carry oxygen around.

IDA occurs because either the RBCs either lack iron, in the form of haemoglobin OR a reduced number of RBCs.

There are other things that can happen to RBCs, they can be too small, too big, be pale (lack of iron) or too dark. There can be either too few of them, or too many.

With IDA due lack of iron RBCs may be normal size or less, and pale.

With IDA due to low numbers, they may be normal, but just not enough.

Since bone marrow is where RBCs are made, a biopsy can indicate exactly what's going on. IDA can be due to many things, some of which happen in the marrow. Think of marrow as a blood making factory.

If you have IDA and have IV iron infusions then you'd expect the IDA to disappear, i.e. haemoglobin levels to go up.

If it doesn't go up then the problem is not simply a matter of a lack of iron. Something else must be happening.

A bone marrow biopsy will help do that.

The procedure can be quite uncomfortable and you should be given a local anaesthetic. It's important that you have it done.

The biopsy should be a part of a series of tests, to find out the cause of your IDA.

As well as a Complete Blood Count you should also have tests for serum iron, transferrin and ferritin.

IDA can cause RLS or make it worse.

If it can be corrected then your RLS, if you have it, may be improved.

However, you may find even that when everything is returned to normal your RLS doesn't improve. In that case you will have to focus on your ferritin level.

I hope this information is helpful.

[Hidden]

Thank you so much for the thorough explanation. As I told LotteM, I don't think I'm having a biopsy done. I think it's an extraction of liquid, using a needle. I will be taking a dose of Lorazepam before the procedure, in addition to getting a local anesthetic.

I've been anemic for years, since the last time I had cancer, but it was never too far off the optimum hemoglobin level. I've been hoping this is the reason that I have RLS. The level went down to 8.1, and I started seeing a hematologist. I had an endoscopy. I had a bleeding stomach ulcer, which explained the low number. Two iron infusions brought my hemoglobin up to only 9.6. My doctor said the infusions should have brought the iron up more, hence the upcoming test.

I doubt it's cancer. I am a three-time survivor, and I get tested regularly for recurrence. I also get immunotherapy treatments every three weeks. I'm full of antibodies! Maybe I don't retain iron because I had cancer. My ferritin level has been recently checked, but I think it was ok. I'm getting an immunotherapy treatment tomorrow, so the ferritin can be checked again.

Thanks again for sharing your knowledge.

[Elffindoe in reply to Hidden]

The bone marrow test is the extraction of marrow, not exactly a liquid. It's more of a gel with the same consistency as

well bone marrow.

The marrow is then examined under microscope.

This IS a biopsy. Biopsy is not synonymous with cancer!

Since marrow is found INSIDE bone, it's not as simple as a blood test.

Immunotherapy can prevent marrow from making sufficient RBCs.

[Hidden in reply to Elffindoe]

I found a good article on bone marrow extraction. What I'm having done is a bone marrow aspiration, where liquid is extracted from the marrow. There are several things that the test could reveal, from iron deficiency to blood cancer.

Sorry that this conversation has gone beyond RLS. It started out as looking at iron deficiency and infusions, to find out if anyone who had infusions got any relief from RLS. I really appreciate all of the information you provided.

[Elffindoe in reply to Hidden]

Exactly

[cicek in reply to Hidden]

Mine was actually called a bone marrow biopsy. Sorry I used the word extraction because that's what you used. Pleased don't be afraid. I had a local anesthetic and all I felt was pushing. It is a liquid/gel substance that they take. Two samples were taken from me and they did show me them! As I said, mine was to test for Polycythemia so it doesn't have to be cancer. It's a through screening for lots of thinks. Good luck.

[Hidden in reply to cicek]

Thank you. I'm a little nervous about the pain, but I've been prescribed lorazepam to take before the procedure. I'll deal with the results when the time comes. I'm not a "what if" kind of person.

[cicek in reply to Hidden]

Please don't be. I spent two weeks worrying myself silly but got through it very comfortably. The worst thing is the thinking beforehand but unfortunately we can't help that.

[Hidden in reply to cicek]

Thanks for the encouragement. I'll do my best to just not think about it.

[Butterflysun1]

Bone marrow is where blood cells are manufactured. It doesn’t relate to iron but it is possible to have both low iron and low numbers of blood cells. In the bone marrow there are immature ie just beginning to be made blood cells & mature ones about to be released into the blood. The spectrum, variety and numbers of all these cells indicate what is happening in the ‘blood cell factory ‘ & whether there are any problems at any of the stages.

[Hope61]

I just went with my cousin as she had that procedure last week. She had consistently high white blood cell counts and was diagnosed with a form of Leukemia. The test was ordered to determine if it is acute or not. Because the type she has is very manageable by taking a chemo pill once a day . She has had no side affects from that pill either. You must be your own advocate Ask questions , bring a list of questions so you don't forget anything that you want to ask. Also it's good to have another person with you to hear what the doctor is saying or for you to have a notebook with you to jot down key points in the visit. Sometimes doctors talk so fast or speak in terms that don't make

It easy to understand. So speak up and questioning them is 100% advocating for yourself. Hoping all goes well fir you !!

[Hidden in reply to Hope61]

Thank you! My best wishes to your cousin.