What is a Bone Marrow Test?

Biopsy sampling tools.

Question: What is a Bone Marrow Test?


Biopsy and testing of the bone marrow is required for the initial diagnosis of different types of lymphoma and leukemia. It's also the next step to find a diagnosis when other conditions are suspected, including some infections, some types of anemia, and other blood disorders.


Bone marrow testing can also help determine if cancer has spread or responded to treatment.



The bone marrow is a soft pulpy tissue found inside some bones in the body. It contains cells that ultimately develop into the different types of blood cells - red blood cells, white blood cells and platelets.

Doctors sample the bone marrow:

There are different techniques for obtaining bone marrow -- including aspiration and different types of biopsy. More than one technique may be used. In aspiration, a thin needle is used to suck out some cells from the marrow. In a bone marrow biopsy a small tissue piece is removed intact from the marrow using a thicker needle. Aspiration can provide a good sample of cells but does not allow pathologists to see what’s known as the bone marrow architecture, or the arrangement and organization of the marrow cells. The larger sample from a bone marrow biopsy does provide this view. Also, the larger sample provided by biopsy is needed for the initial diagnosis of a cancer like lymphoma, which requires enough material for all of the laboratory tests that may need to be done.

Pathologists analyze it and run lab tests:

A complete diagnosis may require multiple tests on the biopsied material. These include not just visualization of the cells using a microscope, but also counting and sorting the different cell types present, special stains and tests to identify tiny markers on the outside of cells and tests to identify specific genes or parts of genes.


Cheson B, Fisher R, Barrington S, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059-68.

Illustrated Pathology of the Bone Marrow; Attilio Orazi, Dennis P. O'Malley, Daniel A. Arber.  Cambridge University Press, Jul 20, 2006.

University of Maryland Medical Center. Bone marrow biopsy. Accessed October 2015.

Updated October 2015.

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