Bone marrow examination is a basic method in hematological diagnosis, necessary for making a diagnosis and evaluating the effects of treatment of many diseases. A physician performs the procedure. Bone marrow biopsy, so-called aspiration biopsy, is performed with a thin needle and allows the collection of bone marrow cells for cytological examination, but also highly specialized cytogenetic or molecular studies. There are no significant contraindications to performing an aspiration biopsy, except for inflammatory or infectious lesions of the skin at the site of the potential prick.

The examination is performed in the supine position or on the side (biopsy of the iliac plate – near the posterior superior iliac spine) or on the back (biopsy of the sternum – near the handle of the sternum). The procedure takes several to several minutes. After the biopsy site is decontaminated, local anesthesia is administered, and then the actual procedure begins – the biopsy needle is inserted sequentially through the skin, connective tissues and muscles, and then into the spongy substance of the bone, which is the proper place for bone marrow aspiration. Some patients may experience discomfort during and after the procedure despite the local anesthesia used, as it is impossible to anesthetize the marrow cavity. After aspiration of the bone marrow, the biopsy needle is removed, the puncture site is compressed and secured with a sterile dressing, and the puncture site is recommended to be compressed. Thirty minutes after the procedure, the biopsy site is inspected and, if there are no complications, the patient is allowed to leave the medical facility.

Complications of the procedure are relatively rare, and the procedure itself is considered safe. The most commonly observed complications include pain and bleeding from around the biopsy site, skin irritation and the development of local inflammation. Serious complications are observed very rarely. These include, in the case of a sternum biopsy, its puncture, damage to the arterial vessels and the heart below the bone, and damage to the pelvic vessels in the case of a hip plate biopsy. However, these complications are observed very rarely, mainly in patients with advanced bone disease (osteoporosis, plasmocytic myeloma, after surgery). Needles with special puncture depth limiters are used to reduce the risk of their occurrence. In addition, allergy or anaphylactic shock to the local anesthesia or disinfectants may also occur.