Answering Questions About Bone Marrow Aspirations and Biopsies

If you have CML, it’s likely that you’ve already experienced a bone marrow aspiration or biopsy. These procedures are typically the first steps in diagnosing and/or confirming the type of leukemia one currently has. For CML patients, biopsies or aspirations are used to identify the Philadelphia Chromosome, or the translocation of the ends of chromosomes 9 and 22.

The National CML Society partners with CML experts throughout the nation to answer your questions about all things CML. This feature is found at our Ask the CML Experts portal. Here are four commonly asked questions and answers about bone marrow aspiration/biopsy frequency, distinctions, complications, and procedures.

Illustration of a bone marrow biopsy

Illustration of a bone marrow biopsy

  • How often should a CML patient anticipate having a bone marrow aspiration or biopsy?

    The Bone Marrow Aspiration/Biopsy (BMA/B) procedure may be done periodically throughout a person’s treatment for Chronic Myelogenous Leukemia. The frequency can vary from physician to physician but most can anticipate the procedure at the time of diagnosis and perhaps yearly or more frequently until a deep response is achieved and maintained over time. Frequency may increase if incremental peripheral blood tests indicate a failure to achieve response milestones, particularly during the first 18 months of therapy.

    A new set of guidelines are currently under consideration that would call for a BMA/B at the time of diagnosis and another at three months. At the three month test, if response has been acceptable, or beyond, patients may be able to go long term without having to have the procedure as frequently. As stated above, frequency may increase if peripheral blood tests indicate a loss of response or failure to achieve and maintain response milestones.

    Patients participating in a clinical trial will find the trial protocol may stipulate a BMA/B schedule, which might be as frequent as every month.

  • What’s the difference between a bone marrow aspiration and a bone marrow biopsy?

    The bone marrow aspiration (BMA) removes a small amount of bone marrow fluid and cells through a needle placed into the bone, generally the pelvic bone. Less frequently, the sternum may also be used as a bone marrow aspiration site.

    The bone marrow biopsy (BMB) removes a small amount of bone and is done at the same time as the aspiration.

  • Can there be complications from a bone marrow procedure?

    Complications, although rare, but may include excessive bleeding at the collection site or infection. Patients should contact their doctor promptly if they experience persistent or spreading redness or bleeding at the site, fever, or persistent/increasing pain.

    Patients should tell their doctor about any medications and/or supplements they are taking prior to the procedure.

  • Will I be put to sleep to have a bone marrow procedure?

    This varies greatly, however it is usually not necessary. You may be given a sedative and a local anesthetic to ease any discomfort from the procedure. It is not out of the question to ask for the procedure to be done under sedation, however, this should be discussed with your doctor well in advance of the day of the appointment.

As always, if you have any other questions regarding these procedures, feel encouraged to ask your doctor about what is suitable for your personal needs and treatment. Based off of your history, TKI, and personalized treatment goals, they will best be able to answer any specific questions you may have.


  • Val Parr

    Is treatment for cml leukemia ever done without a bone marrow biopsy?