How is bone marrow taken?

Have a look at this:

http://www.nhs.uk/conditions/bone-marrow-donation/Pages/Introduction.aspx

and

http://www.nhs.uk/Conditions/Bone-marrow-donation/Pages/How-is-it-performed.aspx

I have to say, it's a brave person who goes through that for a total stranger

shibby said:

Hey everyone,

Just wanted to know:-

A) How do they take bone marrow?
B) Is it something a Dr could do alone or would they need a team?
C) How long does it take?
D) After it's done can the patient get up and go? Or would they need to stay for a while?
E) Is the patient awake whilst it happens?

Any other info would be really appreciated too.

Thanks

Shibby

Click to expand...

Had one a few months ago
A- With a f##king big needle into your pelvic bone.
B- Consultant + 1 nurse assisting did it.
C- Maybe 10 mins - feels like forever
D- Drove home 15 mins later
E Unfortunately so, had a local aneasthetic spray on the area so I did feel it on my skin, but you can't anaesthetise bone!

Wow.... when I did this procedure on dogs, we always anesthetized, or at least heavily sedated. I feel really bad for humans, now! Having someone punch a needle through your bone isn't something I'd want done to me without sedation and onboard pain control before they started.

Also, just fyi, you can take samples from the pelvis, and this is most common, but you can also take it from the sternum.

What kind of marrow harvest are you looking for? Is it for diagnostic purposes (sounds like that’s what happened to Mr. Maryn and waylander) or are they harvesting marrow for a donation? It makes a pretty big difference.

A marrow donation is a much more involved procedure than a marrow biopsy/aspiration. The amount taken is much larger ( ~ 1 liter). It happens under general anesthesia, takes about one to two hours and the donor usually spends about a day in the hospital.

waylander said:

E Unfortunately so, had a local aneasthetic spray on the area so I did feel it on my skin, but you can't anaesthetise bone!

Click to expand...

Bones have no nociception. Only the tissue layer surrounding them, the periosteum, does.

asroc said:

What kind of marrow harvest are you looking for? Is it for diagnostic purposes (sounds like that’s what happened to Mr. Maryn and waylander) or are they harvesting marrow for a donation? It makes a pretty big difference.

A marrow donation is a much more involved procedure than a marrow biopsy/aspiration. The amount taken is much larger ( ~ 1 liter). It happens under general anesthesia, takes about one to two hours and the donor usually spends about a day in the hospital.



Bones have no nociception. Only the tissue layer surrounding them, the periosteum, does.

Click to expand...

According to the consultant who carried out the procedure it was recently discovered that there are nerves in bone. The discomfort I felt supports this.

Mine was also small sample for diagnostic purposes

waylander said:

According to the consultant who carried out the procedure it was recently discovered that there are nerves in bone. The discomfort I felt supports this.

Mine was also small sample for diagnostic purposes

Click to expand...

You're right, there are also nociceptors in the endosteum, which covers the bone tissue from the inside. (Histology, my ancient enemy, you strike again.)

Maryn said:

[Mr. Maryn's was not for diagnostic purposes. They harvested marrow, killed all the remaining marrow so it could no longer produce defective blood cells, then gave him back his own marrow, which was producing some "correct" cells, and kicked it into overdrive.]

Click to expand...

That's interesting, how long ago was this? AFAIK, the standard today for adults is to take the stem cells from the peripheral blood stream.

I don't know if it helps, but I underwent a peripheral stem cell donation a few years ago to help someone with a blood cancer. If you want to know what it was like from the donation side, I'd be happy to tell you my experience. They said to me that as often as possible that's how they ask donors to help these days, but I was prepared to donate via bone marrow extraction if the patient required it. The only thing I can't answer was the eventual outcome because it was all anonymous, but I still have the thankyou card the transplant register passed on.

When I first signed up to the register, which was probably the early 2000s, not only was peripheral stem cell donation not a thing, but also you could only get on the register by donating a blood sample.

By the time I gave my donation about 10 years later, peripheral stem cell donation was the preferred donor method, and you could get on the register through a saliva swab.

The tests they put me through to make sure donation was safe for me took a whole day, and included a chest xray, which oddly they gave me a copy of on CD!

The absolute best part of it was that I got a cold the week of donation (which wasn't a problem for them as long as I was happy to donate). Of course, that alongside the treatment sent my white cell count through the roof and I felt disproportionately ill. When they did the stem cell collection, the white cells were filtered out, so in the space of 4 hours I went from 'I feel horrible' to 'oh, I'm well, this is cool!'

Medical science changes super fast!

Well, if it's sci fi you can have them take it however suits your story, surely?

There was an episode of House, M.D. where one of the doctors decided to take bone marrow from a 12-year-old and donate it to the kid's sick older brother. The kid was willing, at first. But he was too sick for general anesthesia, so they did it awake. After the first plunge of the needle, the kid started screaming for the doctor to stop, but the doctor went crazy, determined to save the other kid's life, and kept going. They called it "medical torture" and since it saved the other kid, they didn't fire him or sue him, but geez, they should have! It was horrifying just to watch, I can't imagine going through something like that.

Regarding cloning, in an episode of Star Trek: The Next Generation, they established that the best cells for cloning are from the stomach lining. Some colonists stole stomach cells to grow clones from, only they got caught because the doctor figured it out in time. It's one of my favorite episodes, actually.

But hey, it's the future, right? You could have them "beam" the marrow out from the bones, instead of using primitive needles to suck it out. No harm to the patient!

I know I'm late to reply, but I received a bone marrow/stem cell transplant and my donor gave me his immune system via blood rather than from the marrow. This was in 2010 and here is how it worked: he (and I too as aback up in case my body didn't accept his cells and I needed to get my own immunity back) took 3 days of injections to express our bodies stem cells into the blood stream. These injections weren't too bad but caused diarrhea and bone pain. After 3 days my donor went through a stem cell collection process via temporary line in his chest (like the ones chemo patients or temporary dialysis patients have). The process takes about 5 hours and is painless. You sit in a chair and a machine filters out the "bad" cells that can cause rejection and keeps the faciliating cells. A few days later I received the transplant via a simple bag of blood in an iv bag. If they hadn't gotten the cells through the stem cell facilitation process, they would have tapped my donor's bone marrow, which is more painful. but the process worked and now I have my donor's DNA in my blood and also my blood type changed from B to O. It is called "mixed chimerism" and means my body and his blood/immune system live in harmony with no rejection issues.

Also, I went through intense chemo and radiation first so my body would accept his cells.

Currently, cloning doesn't really involve bone stem cells at all. It involves the nucleus of a fat cell of a female and the egg of the same female. The nucleus of the egg cell is sucked out and replaced with the fat cell nucleus (which has a full complement of chromosomes.) This is done under very specific conditions--hormones, temp, electrical stimulation. All clones are female. This is how Dolly the sheep was created several years ago.