Bone marrow aspiration and trephine biopsy

These tests are used to examine cells from the bone marrow. You will usually have a local anaesthetic and a mild sedative.

Learn more about:

• Bone marrow aspiration and trephine biopsy
• Cytogenetic and molecular tests

Bone marrow aspiration and trephine biopsy

For the bone marrow aspiration, a thin needle is used to remove a sample of fluid (aspirate) from the bone marrow – usually from the pelvic bone, but sometimes from the chest. A trephine biopsy, sometimes done with a second needle, removes a small piece of bone with the marrow inside.

The bone marrow samples are sent to a laboratory for examination under a microscope. A medical specialist, called a pathologist, will check the number of plasma cells in the sample and look for any damage to the bone marrow caused by myeloma.

You may also have a bone marrow aspiration and trephine biopsy at the start and end of each course of treatment. By comparing samples, your doctor can see how well the treatment is working.

Cytogenetic and molecular tests

The bone marrow sample may be used for cytogenetic and molecular tests, which examine the structure and function of cells. Each cell in the body contains chromosomes, which are made up of genes. These genes control all activities of the cell.

There may be changes in the structure of the chromosomes within myeloma cells, such as a part missing or deleted. The most common chromosomal abnormalities found in myeloma include t(4;14), t(14;16), del(17p) and del(13q). The changes help classify myeloma as either high risk or standard risk.

Cytogenetic, fluorescence in situ hybridisation (FISH) or other specialised molecular tests can look for changes in the chromosomes. By identifying any changed or damaged chromosomes, genetic tests help the medical team plan the most effective treatment and predict how the myeloma might respond.

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