Aplastic Anemia — Bone Marrow Evaluation — Clinical Pathway

Aplastic Anemia Clinical Pathway — All Settings

Bone Marrow Evaluation

Please contact the Bone Marrow Failure Team prior to performing a bone marrow biopsy & aspiration.

The team prefers to speak with the family about the Bone Marrow Failure Research Study and discuss the possibility of obtaining a skin biopsy at the time of the marrow aspiration and biopsy.

1. Bone Marrow Aspirate

To Order/Include Ordering Guidance
Aspirate 15 mL
Bone Marrow Report  
T-cell Receptor Gene Rearrangement  
Cytogenetics
Performed in Cancer Cytogenetics Laboratory
  • Order in Epic as
    • Cancer, chromosome analysis (Karyotype)
    • Cancer, SNP Array
    • Cancer, FISH (order only if specific cytogenetic lesion suspected)
    • Somatic Heme Panel
Flow Cytometry Leukemia/Lymphoma Screen Panel only if clinically indicated
Iron Stain  

2. Bone Marrow Biopsy

To Order/Include Ordering Guidance
Biopsy
  • 1.5-2 cm minimum length of core (needed for cellularity assessment)
    • Order in Epic as: Bone Marrow Core

3. Skin Biopsy

To Order/Include Ordering Guidance
2-3.5 mm punch biopsy performed at bone marrow biopsy site
Recommended for all patients for purposes of inherited predisposition testing using skin fibroblasts
  • Order in EPIC as: Grow and Store Cell Line in Cytogenomics
  • Laboratory
    • Biopsy needs to be done by a member of the BMF team.