Bone Marrow Biopsies: ‘A Vital Part of Diagnosing and Staging Multiple Myeloma’
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/ Updated February 11th, 2022

Bone Marrow Biopsies: ‘A Vital Part of Diagnosing and Staging Multiple Myeloma’

Medically Reviewed: Dr. Doris Hansen Written by: Joe Kerwin
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The Purpose and Process of Bone Marrow Biopsies

  • Multiple myeloma is a type of blood cancer. In people with multiple myeloma, cancerous plasma cells produced in the bone marrow crowd out healthy blood cells and create abnormal proteins.
  • Bone marrow biopsies allow doctors to confirm a multiple myeloma diagnosis and collect essential information about the makeup of an individual’s cancer. The procedure is typically performed using the pelvic bone, where the bone is close to the surface.
  • Through bone marrow biopsies, doctors can make predictions about how the cancer may behave, and track the way that the cancer is affected by treatment.
Multiple myeloma is a blood cancer that forms in white blood cells called plasma cells (manufactured in the bone marrow). When functioning properly, plasma cells produce antibodies that attack germs and help fight infections. When someone has multiple myeloma, however, their cancerous plasma cells reproduce abnormally, leaving less space for healthy blood cells. Instead of producing antibodies, these cancerous plasma cells produce problematic abnormal proteins.

Bone Marrow Biopsies: What and Why

A bone marrow biopsy is a procedure in which a doctor uses a large needle to collect a small sample of a bone and bone marrow, as well as the liquid within the bone marrow that contains marrow cells. These samples are typically taken from the pelvic bone. "There's not much else around that space,” said Dr. Matthew Ulrickson of Banner MD Anderson Cancer Center in Gilbert, Arizona. “The bone is close to the surface."

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RELATED: Understanding the Phases of Multiple Myeloma

Dr. Ulrickson pointed out, "Being a blood cancer, the first place the cells are usually seen is within the bone marrow space.” The bone marrow is responsible for producing the plasma cells that become cancerous in multiple myeloma patients.

"The bone marrow space is seen within the hips, the sternum, the ribs, and the center bones of the body, and so the only way to access that is through a bone marrow biopsy," Dr. Ulrickson explained.

What Do Bone Marrow Biopsies Tell Us?

According to Dr. Ulrickson, bone marrow biopsies accomplish four important tasks. Bone marrow biopsies:

  • Confirm a multiple myeloma diagnosis
  • Identify specific features of an individual's cancer so doctors can personalize treatment
  • Project into the future, predicting how the disease might spread
  • Enable doctors to monitor how the cancer responds to treatment

RELATED: Making a Multiple Myeloma Treatment Plan

What Is in a Bone Marrow Sample?

Doctors use a needle to collect two types of samples, from which they can gather a wealth of information about the disease:

  • The first is a fluid sample that looks like blood–it is called the aspirate. "It helps us to look at the cells, to count the number of plasma cells that are present in multiple myeloma, but also to send additional studies that look at the chromosomes or the genes of the multiple myeloma cells," Dr. Ulrickson said.
  • The second portion of the sample is called the core biopsy. "The core biopsy helps us to give the cells structure around them and gives additional information about how many cells are present when compared to all of the cells of the bone marrow."

Dr. Ulrickson stressed the value of this information in constructing a treatment plan, calling the bone marrow biopsy "a vital part of diagnosing and staging multiple myeloma."

Genome Sequencing

One of the ways that doctors gather information from bone marrow biopsies is through genome sequencing. This process analyzes the DNA of multiple myeloma cells. Cancerous cells contain mutations that can help doctors understand how your specific case of multiple myeloma works: how it grows, how it tries to thwart the immune system, and how it might respond to different therapies.

Learn more about SurvivorNet's rigorous medical review process.

Joe Kerwin is a writer and researcher at SurvivorNet, based in New York City. Read More

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