Sternal Bone Marrow Aspiration
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Sternal bone marrow aspiration is a diagnostic procedure in which a physician collects a small amount of liquid bone marrow (bone marrow aspirate) from the stern using a special needle.
The collected aspirate is used for laboratory testing to evaluate blood cell formation, diagnose hematological disorders, and monitor treatment effectiveness.
The procedure is performed by a hematologist under sterile conditions, usually with local anesthesia. Its purpose is solely to obtain bone marrow material for laboratory analysis; the final diagnosis is established based on laboratory findings together with the patient's clinical evaluation.
Indications
Sternal bone marrow aspiration may be recommended for:
- anemia, leukopenia, neutropenia, thrombocytopenia, or pancytopenia of unknown origin;
- persistent elevation of white blood cells, platelets, or red blood cells;
- detection of blast cells, atypical cells, or other abnormal cells in peripheral blood;
- suspected acute or chronic leukemia;
- suspected myelodysplastic syndromes or myeloproliferative neoplasms;
- evaluation of disorders of blood cell production;
- monitoring response to treatment;
- confirmation of remission or evaluation of suspected disease relapse;
- other indications determined by a hematologist.
Procedure
The patient lies on their back. After disinfecting the skin, the physician administers local anesthesia to the puncture site.
Once anesthesia has taken effect, a small amount of bone marrow is aspirated from the stern using a specialized needle. During aspiration, the patient may experience a brief sensation of pressure or sharp pain that usually lasts only a few seconds.
After the sample is collected, the needle is removed, a sterile dressing is applied to the puncture site, and the specimen is immediately sent for the requested laboratory tests.
Advantages
- collection of high-quality bone marrow aspirate for laboratory analysis;
- an important diagnostic method for hematological diseases;
- enables cytomorphological, immunophenotypic, cytogenetic, and molecular genetic testing;
- high diagnostic value in the comprehensive evaluation of blood disorders;
- useful for monitoring treatment effectiveness and confirming remission;
- performed under local anesthesia;
- short procedure duration.
Medical sources:
https://www.researchgate.net/figure/Sternal-puncture-A-Location-of-the-sternal-puncture-site-The-sternal-angle-formed-by_fig3_284069321
https://pmc.ncbi.nlm.nih.gov/articles/PMC1770618/
https://pdfs.semanticscholar.org/1fba/d1ea3d9132882d5735f8dc524c739c60a672.pdf
https://www.wikilectures.eu/w/Sternal_puncture_(pediatrics)
https://link.springer.com/chapter/10.1007/978-3-642-96116-8_1
Preparation:
Before the procedure, inform your physician about:
- all medications and dietary supplements you are taking;
- the use of anticoagulants or antiplatelet medications;
- any bleeding disorders or history of excessive bleeding;
- allergies to medications or local anesthetics;
- chronic medical conditions and ongoing treatments.
Do not stop taking any prescribed medications unless instructed by your physician.
Before the procedure, your physician may request a complete blood count, platelet count, and, if indicated, coagulation tests.
If the procedure is performed under local anesthesia only, no special preparation is usually required. If sedation is planned, follow your physician's instructions regarding food and fluid intake and arrange for accompaniment after the procedure.
