Do I need a bone marrow biopsy?

In CLL, usually you do not need to do a bone
marrow biopsy to establish the diagnosis.

However, on clinical trials, often
a bone marrow biopsy is required

And to establish
 a complete remission,

you still have to do a bone marrow
to show that you have cleared the disease

not only from the blood
but from the bone marrow as well.

So in routine clinical practice,

outside of the context of trials, patients
don't usually need a bone marrow biopsy.

But on clinical trials,
especially to establish

a complete remission,
then a bone marrow biopsy is needed.

It used to be that in the past

that prognostic information
from the bone marrow,

whether you had a nodular infiltration
pattern or diffuse, was prognostic.

But that is no longer of much importance.

Bone marrow biopsies are

usually not a part of the follow up
care for these patients,

as most of our information can be obtained
from peripheral blood analysis as well.

So we restrict, really restrict
the use of bone marrow biopsies

to unique situation where it may offer

more information than what
a bit of a blood sample may tell you about.