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Bone Marrow Tests
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Bone Marrow Tests

Bone marrow tests, including aspiration and biopsy, are diagnostic procedures used to evaluate the production of blood cells and identify disorders or cancers affecting the bone marrow.

Overview

Bone marrow is a soft, spongy tissue found in the center of your bones. It makes different types of blood cells, including:

  • Red blood cells (erythrocytes), which carry oxygen from your lungs to every cell in your body.
  • White blood cells (leukocytes), which help you fight infections.
  • Platelets, which help with blood clotting.

Bone marrow tests remove a sample of your bone marrow and bone, usually from the back of the hip, to be examined under a microscope. There are two types of procedures used to collect these samples:

  • Bone marrow aspiration removes a small amount of fluid and cells from your bone marrow.
  • Bone marrow biopsy removes a small piece of bone and bone marrow.

These procedures are usually done at the same time.

What are they used for?

Bone marrow tests help find the cause of abnormal blood cell counts. Results can help:

  • Diagnose blood and bone marrow disorders, such as anemia, hemochromatosis, myelodysplastic syndromes, polycythemia vera, platelet disorders, and certain cancers like leukemia, multiple myeloma, and lymphoma.
  • Plan and monitor treatment for blood or bone marrow conditions.
  • Determine if cancers like breast, lung, or prostate cancer have spread to the bone marrow.
  • Find the cause of an unexplained fever.

Why do I need bone marrow tests?

You may need these tests if you have had abnormal results on other blood tests (such as a complete blood count), have symptoms of a bone marrow disease, require cancer staging, or need to monitor how well a treatment is working.

What happens during a bone marrow test?

The procedure typically takes about ten minutes. You may receive a sedative to help you relax or stronger medicine to make you sleep. During the procedure:

  • You will lie on your side or stomach, typically with the sample taken from the iliac crest (back of the hip).
  • The area is cleaned and numbed with an injection.
  • A small incision is made, and a hollow needle is inserted.
  • For aspiration, a syringe is used to remove bone marrow fluid.
  • For biopsy, the needle is twisted to remove a small piece of bone marrow tissue.

After the test, the site is bandaged. You may need to avoid hard physical activity and keep the bandage dry for at least a day. Soreness may persist for a week or more.

Preparation and Risks

Tell your provider about all medicines you take and any bleeding disorders. You may need to fast before the procedure. Because you may be drowsy from sedation, plan to have someone take you home.

Risks are rare but include stiffness, soreness, or pain at the site. Serious symptoms, which require calling your provider, include increased pain, redness, swelling, fluid leakage, or fever.

Frequently Asked Questions

Preliminary results from the aspirate may be available within a few days, but a complete analysis of the biopsy, including special stains and genetic testing, can take one to two weeks or longer. Abnormal findings can indicate a wide range of conditions, including bone marrow failure syndromes, infections, storage diseases, or malignancies. The specific pattern of cell changes, such as an increase in immature cells or the presence of abnormal proteins, helps the hematologist distinguish between different diagnoses and determine the appropriate next steps for treatment.
Preparation usually involves fasting for a few hours if sedation or general anesthesia is planned, and you may be asked to stop blood-thinning medications like warfarin or aspirin for a specified period before the procedure. You will need to arrange for someone to drive you home if sedation is used. Common risks include pain at the puncture site, minor bleeding, and bruising. More serious but rare complications include infection, significant bleeding, or damage to nearby nerves or organs. Your healthcare team will review your medical history and current medications to minimize these risks.
n aspiration uses a thin needle to withdraw liquid marrow and cells, which is excellent for examining cell morphology and counting specific cell types. A biopsy uses a thicker needle to extract a small solid cylinder of bone and marrow, which preserves the tissue architecture and helps assess the overall structure and density of the marrow. Both are typically performed during the same procedure because they provide complementary information; the aspiration gives a snapshot of the cell population, while the biopsy reveals how those cells are organized within the bone, which is crucial for diagnosing conditions like myelofibrosis or certain leukemias.
While bone marrow tests are primarily used to diagnose and stage blood cancers such as leukemia, lymphoma, and multiple myeloma, they are also used to check for metastasis from solid tumors. Cancers originating in the breast, lung, prostate, or colon can sometimes spread to the bone marrow. Therefore, a bone marrow test can help determine if a solid tumor has metastasized, which significantly impacts treatment planning and prognosis, even though the primary cancer did not start in the marrow.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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