Bone Marrow Aspiration and Biopsy Indications

Bone marrow examination consists of aspiration that provides a cellular smear for morphology and biopsy that captures architecture, cellularity and fibrosis. The two procedures are usually performed together at the posterior iliac crest under local anesthesia and provide complementary information for hematological diagnosis.

Standard indications include unexplained cytopenia or cytosis, suspected leukemia or lymphoma, monoclonal gammopathy with end organ disease, staging of solid tumors, evaluation of fever of unknown origin and characterisation of myelodysplastic syndrome. Repeat marrow studies are used to assess response to therapy and to detect minimal residual disease.

Specimens are sent for morphology, flow cytometric immunophenotyping, cytogenetics and targeted molecular panels. Modern integrated reports combine these data to define disease subtype, prognostic risk and actionable mutations and so guide therapy and transplant decisions in hematology and oncology.