Bone Marrow Failure: Tests and Diagnosis


What tests are used to diagnose bone marrow failure?

Blood tests and a bone marrow aspirate and biopsy are the tests used to diagnose bone marrow failure. From your child's blood sample, a complete blood count (CBC) will be done to count the number of red blood cells, white blood cells and platelets that are circulating in your child's blood stream. Because all or most cell numbers are low in aplastic anemia, patients usually have lower than expected CBCs. Reticulocytes, newly formed red cells, will also be counted and are usually low in children with bone marrow failure.

The definitive test is a bone marrow aspirate and biopsy, which is performed in an operating room while your child is asleep to prevent him or her from feeling pain. During the biopsy, a special needle is used to take about a teaspoon of marrow for your child's back hip bones. The sample of marrow and bone is examined under a microscope by a hematologist (blood doctor) and pathologist (doctor who examines cells) to diagnose bone marrow failure.

What to expect from blood and bone marrow tests

The results of CBC and reticulocyte counts are available within an hour. Bone marrow tests are available within 24 hours or sometimes sooner.

How do providers at Children's Hospital Colorado make a diagnosis?

When a patient comes to Children's Colorado with bleeding or bruising or extreme paleness, your doctor will request a blood test for a complete blood count (CBC). If your child's testing shows a combination of low red blood cells, white blood cells and platelets, bone marrow failure is often suspected. Doctors will then recommend that your child have a bone marrow aspirate and biopsy to confirm the diagnosis.