Why Do You Need a Biopsy?

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Most every MPN (myeloproliferative neoplasm) patient has had a bone marrow biopsy.  MPN experts from MD Anderson Cancer Center, Dr. Srdan Verstovsek and Dr. Carlos Bueso-Ramos, explain why bone marrow biopsy is necessary. Dr. Bueso goes into detail regarding the bone marrow biopsy procedure and how the sample that is collected is not only used for current diagnosis but can also be used for analysis years later.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Joining us first of all is Dr. Srdan Verstovsek, who is a world?renowned MPN expert.  Thank you for being with us for our Ask the Expert program. 

And everything that we see in blood comes from the bone marrow.  Bone marrow is the soft tissue in the middle of the big bones in the body that reduces blood.  So if something is wrong with the blood count, blood cell types or organs that are involved in the blood, like the spleen, then we go after the source of these cells.  And this is where we go, to the bone marrow with doing the bone marrow procedures that we call bone marrow biopsy, which is not that simple, as you pointed out.  It has a lot of aspects to it, and I hope today we will dissect that process.

Dr. Bueso, let's get to you.  So when I've had a bone marrow biopsy, like my patient friends around the world, you're extracting something, blood.  I don't totally understand, and I'm never looking, of course, because we're face down, and that's going to your lab.  What are you looking for there?  What are you trying to determine, and what are you getting from us so that you can make a determination and give information, a report, back to our doctor? 

If they don't see anything, they call it a dry tap.  And it can be either caused by bad technique or maybe because your marrow has a pack component or is very fibrotic and is not releasing those cells.  So the first pull is the key one for a high-quality smear.  We make a lot, as you can see here.  We make at least 20 for you, and we stain at least five, and we leave the others as a backup because we don't want you to repeat this procedure. 

The second pull will be cytogenetics.  You see they will tell you, now you're going to feel a second pull, and this syringe here will have happening (phonetic), and they will put one or two mls in this happening, too, and this will be sent to cytogenetics to analyze what is in your chromosomes, these little components in your body that has the genes that decide some of the key functions of your blood?forming cells. 

By the time they collect the happening, this thing will have clotted.  Whatever they didn't use in your first pull is called a clot.  The Formalin is just like a gelatin red.  They will squeeze the gelatin into a formalin fixative, and it's going to be submitted for additional studies. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on May 20, 2014