Bone marrow biopsy morbidity and mortality

Abstract

Summary. A postal survey of adverse events associated with bone marrow biopsy (aspiration biopsy with or without trephine biopsy) was carried out among British Society of Haematology members, between 1995 and 2001. A total of 26 adverse events, including one death directly attributable to the procedure, were reported among an estimated 54 890 biopsies. The most frequent and most serious adverse event was haemorrhage, reported in 14 patients, necessitating blood transfusion in six patients and leading to the single death. The potential risk factors most often associated with haemorrhage were a diagnosis of a myeloproliferative disorder, aspirin therapy or both. Other potential risk factors were warfarin therapy, disseminated intravascular coagulation and obesity.

Bone marrow biopsy related haemorrhage and low molecular weight heparin

“…We agree with Bain (2003) that haemorrhage post bone marrow examination is likely to be more frequent in patients with myeloproliferative disorders, those on treatment with aspirin or warfarin and where there is presence of disseminated intravascular coagulation or obesity, but we believe that treatment with LMWH at therapeutic doses should also be included in the list of risk factors. Although it is unclear whether prophylactic doses of LMWH would be associated with haemorrhage post bone marrow examination, because they are administered once daily it would be sensible to delay the dose on the day of the biopsy until 6-8 hours after the procedure.…”

Morbidity and mortality of deep sedation in outpatient bone marrow biopsy

“…When the sternum was a popular site for aspiration, case reports were published regarding mortality due to the bone-marrow needle perforating the great vessels, myocardium, and pericardium [24]. A recently published postal survey of members of the British Society of Haematology reported one death out of an estimated 54,890 BMBAs due to hemorrhage caused by the BMBA procedure itself [19].…”

Comparison between Use of PSA Kinetics and Bone Marrow Micrometastasis to Define Local or Systemic Relapse in Men with Biochemical Failure after Radical Prostatectomy for Prostate Cancer

“…The morbidity and mortality of a bone marrow biopsy is low, with a reported adverse event rate of 0.04% (Bain, 2003), the use of touch preps avoids the necessity of decalcification of the sample and thus avoids destruction of epitopes. Possibly more important is that prostate cells detected in bone marrow aspirates may not represent true micrometastasis; having the same phenotype as cells circulating in the blood but different from those found in bone marrow biopsies (Murray et al, 2012).…”