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Your bone marrow produces most of the cells that circulate through your bloodstream.
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Bone marrow is a soft, living tissue found inside your bones. Most of the cells that circulate through your bloodstream -- your red blood cells, white blood cells and platelets -- are produced in the marrow of your pelvic bones, ribs, breastbone, shoulder blades and skull. In most cases, the integrity of your bone marrow can be estimated by taking blood from a vein and evaluating the cells in the small sample. If you develop a condition that suggests marrow dysfunction, your doctor may order a bone marrow biopsy, in which a sample of your bone marrow is taken.
The hallmark of anemia is a decreased number of red blood cells in your circulation. Anemia results from any condition that causes blood loss, destruction of the red blood cells in your circulation or decreased red blood cell production in your bone marrow. Many causes of anemia can be diagnosed with relatively simple tests, such as checking your iron level or testing your stool for blood. If the cause of your anemia is unclear, a bone marrow biopsy may be needed to clarify your diagnosis and guide treatment.
Pure red cell aplasia, a rare cause of anemia resulting from a reduction of red blood cell precursors in your bone marrow, may be difficult to diagnose without a bone marrow biopsy. Primary care physicians often fail to diagnose pure red cell aplasia, according to a 2012 review in вЂњThe Scientific World Journal.вЂќ People with this condition are eventually diagnosed when they are referred to a specialist who performs the necessary bone marrow biopsy.
Abnormal White Blood Cell Count
It is not unusual for a doctor to discover an abnormally high or low white blood cell count during a routine checkup, and abnormal white counts are quite common in people who are ill. If your white count is not markedly abnormal, your doctor may simply recheck your blood several weeks after your first test. If your white blood cell count is extremely high or low, your doctor may order a bone marrow biopsy.
Aplastic anemia is a condition marked by a profound reduction in your bone marrow's ability to produce red blood cells, white blood cells and platelets. If your blood count reveals a reduction in all of your blood cells, your physician may order a bone marrow biopsy to determine whether you have aplastic anemia.
An extremely high white blood cell count, which is the hallmark of leukemia, may also prompt a bone marrow biopsy. According to a June 2011 report in вЂњExpert Review of Hematology,вЂќ a bone marrow biopsy establishes a diagnosis, helps guide treatment and predicts outcomes in people with leukemia.
High or Low Platelet Count
The megakaryocytes, which are large cells in your bone marrow, produce platelets. Once they are released into your bloodstream, platelets participate in blood clotting. If you have too few or too many platelets in your bloodstream, clotting may be slower or faster than normal. If you develop clotting abnormalities, and your doctor discovers an abnormal platelet count on a blood test, a bone marrow biopsy may be a necessary part of your evaluation.
Diagnosing and Staging Cancer
Many cancers either have their origins in bone marrow -- multiple myeloma and leukemia, for example -- or may eventually spread to bone marrow. A bone marrow biopsy confirms a diagnosis and helps guide therapy for cancers that arise from bone marrow. For tumors that spread to bone marrow, such as lung, breast, prostate, stomach, thyroid and kidney cancers, a bone marrow biopsy is necessary for staging. The discovery of one of these cancers in your bone marrow may affect the type of treatment you receive and alter your prognosis.