Bone Marrow Puncture


A bone marrow puncture is an invasive procedure in which a tissue sample is taken from the bone marrow using a special needle or punch. The sample is aspirated through the needle from either the iliac crest or the sternum and contains cells of the haematopoietic and immune systems. Subsequently, it can be examined with a microscope or evaluated by immunohistochemical analysis. Bone marrow aspiration is often used to diagnose diseases such as leukemia or, more rarely, to treat diseases.

Indications for bone marrow aspiration

The indications for bone marrow aspiration are very diverse. However, most of the indications are related to diseases of the haematopoietic system or diseases of the cells of the immune system. Furthermore, a distinction must be made as to whether a disease is already present and the puncture serves for further diagnostics or whether there is a suspicion of a disease and the puncture serves for clarification.

A bone marrow puncture can also serve to monitor the course of some diseases. If a disease is to be confirmed and further clarified by a bone marrow puncture, there are usually too many or too few cells of the hematopoietic or immune system. This is called agranulocytosis or granulocytopenia, for example.

Thrombocytosis or thrombocytopenia may also be present. This only affects one group of cells. If all cells in the bone marrow are affected, this is called pancytopenia.

In contrast, a bone marrow puncture is used to diagnose a suspected case of leukemia. The main focus is on the cells of the immune system, which may show structural changes. This concerns, for example, the diseases of chronic myeloid leukemia or chronic lymphatic leukemia.

The acute form of the disease can also be detected in this way. Furthermore, if lymphoma or a bone metastasis of a cancer focus is suspected, a bone marrow puncture is performed. The puncture is performed to monitor the course of chronic anemia or leukemia.

Sometimes it also happens that the procedure is intended to obtain stem cells, which are important for the treatment of some other diseases. However, this case is rather rare. A puncture is also performed if there is a suspicion of some other diseases, such as changes in bone structure, a high calcium level or hyperthyroidism. This is also rather rare.