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Re: Bone Marrow Biopsy

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Good Lord ,

I am going to have to ask several people to weigh in on this one for several opinions or experiences, but I have never heard of such a method for a BMB. I have had several and each time I was laying flat on my stomach and the doctor approached 'standing' from the side and punched straight down in an area above or over the buttock area, going down into the bone. They said that my bones were hard as well, but I never made contact with the doctor either time other than him touching the area of the BMB.

This assistant laying all over your side sounds very strange to me and I agree with you, I would like to know what others think. I think you may have been handled by someone who has no idea what they are doing, or a bit of a weird character. I hope some others can shed some light on this. This is definitely something everyone should know before having to have this done. Thanks, Kurt

Bone Marrow Biopsy

Hi,I posted last month about just being diagnosed with CLL at age 46. I live in Las Vegas and I have an appt Feb 17 to see Dr. Kipps for a second opinion. I just had the marrow biopsy Friday and I have to say it was terrible. It was not what I was told it would be like. A physician assistant did it. Are they allowed to do them? Do it normally take 45-50 minutes? I didn't expect it to be pleasant but all the info I read about concerning the biopsy didn't prepare me for this....he said it was so hard to do because I have strong bones. He also said he had to go into different places in my hip bone because there were pockets of bone marrow and then there are dry areas? He was literally laying over my side while he was trying to push the needle in. Thanks

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Hi folks, I've had 5 bone marrow biopsies done over the last 6 years.

All except 1 were on my stomach. The side ways one was because the onc said

it was easier for her to get the punch through on the bone. At MD

techs do the biopsies in little closets lined up along a wall---they do 6 at

a time all day long (WHEW!) You want it done by someone who's done a lot of

them. Yes, there are pockets in the marrow so a " dry " hole is possible.

If they get a good specimen they can get more info about your cytogenetics,

cellularity, function of the megakaryoctyes, etc. Good luck, .

Carol Rhoades in Detroit SLL/CLL dx. 98 CHOP x6, Fludara x3, FRC x4 in

01, now platelets crashed and on IVIG going to transplant (allo) soon.

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  • 1 year later...

I hope this is a little easier for the younger kids who might have

slightly softer bones, but for Jan it is just awful. Still, she is good

at it and as been through many (and will be through many more). The

success of her transplant only heightens the need for regular bone

marrow taps.

Sometimes my wife and I are the ones who have to hold her still so that

they can get in the first shot to slightly minimize the pain so that

they can (hopefully) go down the same track with the bit needle and

force it through her hardened adult bones.

Rick ... dad to 21 year old Jan .. now two years post BMT and currently

off any meds for that.

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Hi Rick-

You are probably right. Ethan has always been sedated, so he never

feels any of it (thank God!). It is probably harder on me than

anything. I hate seeing him there like that. The biopsy that was done

on Thursday had to be done twice because the NP forgot another test

that they had to run. Oops...Then she made a comment about

being " retarded " . Well, long story short, she called me later that day

apologizing for her error and insensitivity with her choice of words.

Glad to hear that Jan is feeling better!

I hope this is a little easier for the younger kids who might have

slightly softer bones, but for Jan it is just awful. Still, she is good

at it and as been through many (and will be through many more). The

success of her transplant only heightens the need for regular bone

marrow taps.

Sometimes my wife and I are the ones who have to hold her still so that

they can get in the first shot to slightly minimize the pain so that

they can (hopefully) go down the same track with the bit needle and

force it through her hardened adult bones.

Rick ... dad to 21 year old Jan .. now two years post BMT and currently

off any meds for that.

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  • 1 year later...

>

> My doctor found monoclonal protein in my urine and needs to do blood

> tests and a bone marrow biopsy to determine if I simply have the

> protein (monoclonal gammopathy of undetermined significance) or if I

> am in a stage of progression to a cancerous disorder (like multiple

> myeloma).

>

> Should I be concerned about the anesthetic they give me to do the

> procedure? I don't think I'd be able to do it without it.

>

> How is this related to/caused by candida and how should knowing that

> affect how I choose to monitor/treat this condition? Should I even

> have the bone marrow biopsy?

==>Hi Liz B. No one can advise you as to whether you should do this

procedure or not. It is up to you and your doctor. However, you

should become fully educated about cancer and what it actually IS,

about cancer tests, biopsies, and alternative cancer treatments:

1) See Message #42202 about Cancer Tests.

2) Also see Dr. Simoncini's website - he writes that cancer IS

actually candida/fungus; http://www.curenaturalicancro.com/

3) See the Folder " C) Cancer Causes & Treatments " , particularly the

article " Do Biopsies Intensify Cancer? "

If you believe you have cancer you should find an Orthomolecular

Physician to do intravenous vitamin C treatments.

Bee

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  • 8 months later...
Guest guest

A cytogenetic test done on the bone marrow gives indications on the

eventual presence of extra mutations. About 10% of patients have some

extra mutation at dx, and it may have an impact on treatment. If it is

not done at the beginning and you get into cytogenetic remission there

may not be enough cml cells for this test that looks at only 20 or 30

cells. A FISH test looking at 200-300 cells is in general done on the

same BMB. The quantitative PCR is more precise, it can see one cml

cell in 100000-1000000 normal cells, but is limited to only counting,

it doesn't tell anything about mutations.

Marcos.

On Mon, Jun 30, 2008 at 4:55 PM, serenitywon <serenitywon@...> wrote:

> Hello all,

> I remember being told it is important to have a BMB at time of

> dx.Can someone please explain why it is needed and how it is done? I am

> seeing my Onc tomorrow and what info and questions to be ready.He never

> mentioned having it done and I am almost 4 weeks into gleevec now.

> Thank you

> SharonS

>

>

--

Marcos Perreau Guimaraes

Suppes Brain Lab

Ventura Hall - CSLI

Stanford University

220 Panama street

Stanford CA 94305-4101

650 614 2305

650 630 5015 (cell)

marcospg@...

montereyunderwater@...

www.stanford.edu/~marcospg/

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Guest guest

Hi Sharon, a BMB/BMA (one is a biopsy, the other an aspiration) is done,

depending on where you go, by your doctor, a tech, or a trained nurse. You lie

on your tummy, and they give you lydocane in your hip area, one side or the

other , and this stings a little bit, but it is nothing you can't live with. and

when they determine you are numb enough, they go into the bone marrow and draw

out a sample. If they do a biopsy, they go in again and take a little chip of

the bone. Now as terrible as this sounds, it is not that bad. I have had about

45 of them, and truly never had a BAD one. You should only be in there about 30

min. from start to finish. Some places will give you sedation if you ask for

it, some will not. I used to get sedated, but coming out of the sedation was

more trouble than it was worth. So I guess out of the 45, I was only sedated

3-4 times. Sometimes I take a Valium so I am more relaxed.

I read somewhere in the near future they won't be doing them anymore, now that

would be nice if it were true! Goog luck, Bobby

serenitywon <serenitywon@...> wrote:

Hello all,

I remember being told it is important to have a BMB at time of

dx.Can someone please explain why it is needed and how it is done? I am

seeing my Onc tomorrow and what info and questions to be ready.He never

mentioned having it done and I am almost 4 weeks into gleevec now.

Thank you

SharonS

a (Bobby) Doyle

Brecksville, Ohio, USA

DX 05/1995

02/2000 - Gleevec Trial/OHSU

06/2002 - Gleevec/Trisenox Trial/OHSU

06/2003 - Gleevec/Zarnestra Trial/OHSU

04/2004 - Sprycel Trial/MDACC, CCR in 10 months

#840 - Zavie's Zero Club

09/2006 - out of CCR

04/29/08 - XL228 Trial/ U.of Michigan

06/02/08 - CCR ( in 4 weeks)

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Guest guest

Hi Sharon,

The reason you want to have a BMB or BMA at the beginning of

diagnosis is because it will give you information that you can't get

from any other test. Like the cellularity of your marrow including

if there is fibrosis. It will also give you information about your

chromosomes other than just looking for the Ph chromosome.

Basically, it will tell you if you have any other abnormalities in

your marrow that need to be monitored more closely since some

abnormalities put you at a higher risk.

The other time you want to have a BMB or BMA is to confirm CCR.

While the other tests can give you a good idea that you've reached

CCR, only a BMB/BMA is definitive and this will also give you an idea

of what your PCR value is correlating to your CCR. We all vary to a

degree so in other words, having a BMB/BMA at CCR will allow you to

know that CCR for you personally is 0.XXX. Later when all you get is

PCR tests, you'll know if you slip out of CCR since you have that

bench mark.

I don't know any of the experts who forgo BMB/BMA's on diagnosis or

at CCR but some are no longer doing them after CCR which is a nice

thing. As others have said, they're not a big deal when the doctor

knows how to do them.

Hope that helps,

Tracey

>

> A cytogenetic test done on the bone marrow gives indications on the

> eventual presence of extra mutations. About 10% of patients have

some

> extra mutation at dx, and it may have an impact on treatment. If it

is

> not done at the beginning and you get into cytogenetic remission

there

> may not be enough cml cells for this test that looks at only 20 or

30

> cells. A FISH test looking at 200-300 cells is in general done on

the

> same BMB. The quantitative PCR is more precise, it can see one cml

> cell in 100000-1000000 normal cells, but is limited to only

counting,

> it doesn't tell anything about mutations.

> Marcos.

>

> On Mon, Jun 30, 2008 at 4:55 PM, serenitywon <serenitywon@...>

wrote:

> > Hello all,

> > I remember being told it is important to have a BMB at time of

> > dx.Can someone please explain why it is needed and how it is

done? I am

> > seeing my Onc tomorrow and what info and questions to be ready.He

never

> > mentioned having it done and I am almost 4 weeks into gleevec now.

> > Thank you

> > SharonS

> >

> >

>

>

>

> --

> Marcos Perreau Guimaraes

> Suppes Brain Lab

> Ventura Hall - CSLI

> Stanford University

> 220 Panama street

> Stanford CA 94305-4101

> 650 614 2305

> 650 630 5015 (cell)

> marcospg@...

> montereyunderwater@...

> www.stanford.edu/~marcospg/

>

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  • 2 years later...
Guest guest

I was told that patients must have a bone marrow biopsy before and after tx...is there any way to get around this...i did hear they can use the blood test results...thanksa

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Guest guest

It is your body... you can refuse a BMB

Bone marrow biopsy are no longer routinely recommended in CLL according to the

2008 Guidelines (M. Hallek et al ) for the diagnosis and treatment of chronic

lymphocytic leukemia, at time of diagnosis, but may be required prior to or

after treatment.

" In CLL, characteristically more than 30% of the nucleated cells in the aspirate

are lymphoid. Although the type of marrow infiltration (diffuse vs nondiffuse)

reflects the tumor burden and provides some prognostic information, recent

results suggest that the prognostic value of BM biopsy may now be superseded by

new prognostic markers.

A marrow aspirate and biopsy generally are not required for the diagnosis of

CLL. However, a marrow biopsy and aspirate can help evaluate for factors that

might contribute to cytopenias (anemia, thrombocytopenia) that may or may not be

directly related to leukemia-cell infiltration of the marrow. Because such

factors could influence the susceptibility to drug-induced cytopenias, a marrow

biopsy is recommended before initiating therapy. It is recommended to repeat a

marrow biopsy in patients with persisting cytopenia after treatment to uncover

disease- versus therapy- related causes. "

They are however often required in clinical trials.

You can find a copy here...

http://cllcanada.ca/2010/pages/2008_guidelinesCLL.pdf

The ESMO guidelines state :

" Bone marrow biopsy is not required for diagnosis. A bone marrow biopsy is

recommended before initiating myelosuppressive therapies and for the diagnostic

evaluation of unclear cytopenias. "

~chris

CLL CANADA

>

>

>

>

>

>

>

> I was told that patients must have a bone marrow biopsy before and after

tx...is

> there any way to get around this...i did hear they can use the blood test

> results...

>

> thanks

>

> a

>

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