Iliac crest tap; Sternal tap; Leukemia – bone marrow aspiration; Aplastic anemia – bone marrow aspiration; Myelodysplastic syndrome – bone marrow aspiration; Thrombocytopenia – bone marrow aspiration; Myelofibrosis – bone marrow aspiration

Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination.

Bone marrow aspiration is not the same as bone marrow biopsy. A biopsy removes actual marrow for examination.

How the Test is Performed

Bone marrow aspiration may be done in the health care provider’s office or in a hospital. The bone marrow is removed from your pelvic or breast bone. Sometimes, another bone is selected.

Marrow is removed in the following steps:

• If needed, you are given medicine to help you relax.
• The provider cleans the skin and injects numbing medicine into the area and surface of the bone.
• A special needle is inserted into the bone. The needle has a tube attached to it, which creates suction. A small sample of bone marrow fluid flows into the tube.
• The needle is removed.
• Pressure and then a bandage are applied to the skin.

The bone marrow fluid is sent to a laboratory and examined under a microscope.

How to Prepare for the Test

Tell the provider:

• If you are allergic to any medicines
• If you are pregnant
• If you have bleeding problems
• What medicines you are taking

How the Test will Feel

You will feel a sting and slight burning sensation when the numbing medicine is applied. You may feel pressure as the needle is inserted into the bone, and a sharp and usually painful sucking sensation as the marrow is removed. This feeling lasts for only a few seconds.

Why the Test is Performed

Your doctor may order this test if you have abnormal types or numbers of red or white blood cells or platelets on a complete blood count.

This test is used to diagnose:

• Anemia (some types)
• Infections
• Leukemia
• Other blood cancers and disorders

It may help determine whether cancers have spread or responded to treatment.

Normal Results

The bone marrow should contain the proper number and types of:

• Blood-forming cells
• Connective tissues
• Fat cells

What Abnormal Results Mean

Abnormal results may be due to cancers of the bone marrow, including:

• Acute lymphocytic leukemia (ALL)
• Acute myelogenous leukemia (AML)
• Chronic lymphocytic leukemia (CLL)
• Chronic myelogenous leukemia (CML)

Abnormal results may also be due to other causes, such as:

• Bone marrow doesn’t make enough blood cells (aplastic anemia)
• Bacterial or fungal infections that have spread throughout the body
• Cancer of the lymph tissue (Hodgkin or non-Hodgkin lymphoma )
• A bleeding disorder called idiopathic thrombocytopenic purpura (ITP)
• Blood cancer called ( multiple myeloma )
• Disorder in which the bone marrow is replaced by scar tissue ( myelofibrosis )
• Disorder in which not enough healthy blood cells are made (myelodysplastic syndrome; MDS)
• Abnormally low amount of platelets, which help the blood to clot (primary thrombocytopenia )
• White blood cell cancer called Waldenstrom macroglobulinemia

Risks

There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.

Immunoelectrophoresis – blood

IEP Рserum; Immunoglobulin electrophoresis Рblood; Gamma globulin electrophoresis; Serum immunoglobulin electrophoresis; Amyloidosis Рelectrophoresis serum; Multiple myeloma Рserum electrophoresis; Waldenstr̦m Рserum electrophoresis

Serum immunoelectrophoresis is a lab test that measures proteins called immunoglobulins in the blood. Immunoglobulins are proteins that function as antibodies, which fight infection. There are many types of immunoglobulins. Some can be abnormal and may be due to cancer.

Immunoglobulins can also be measured in the urine.

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

There is no special preparation for this test.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.

Why the Test is Performed

This test is most often used to check the levels of antibodies when certain cancers and other disorders are present or suspected.

Normal Results

A normal (negative) result means that the blood sample had normal types of immunoglobulins. The level of one immunoglobulin was not higher than any other.

What Abnormal Results Mean

Abnormal results may be due to:

• Multiple myeloma (a type of blood cancer)
• Chronic lymphocytic leukemia or Waldenström macroglobulinemia (types of white blood cell cancers)
• Amyloidosis (buildup of abnormal proteins in tissues and organs)
• Lymphoma (cancer of the lymph tissue)
• Kidney failure

Some people have monoclonal immunoglobulins but do not have cancer. This is called monoclonal gammopathy of unknown significance, or MGUS.

Risks

There is very little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling lightheaded
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)