Contraindications
There are no absolute contraindications for marrow aspiration and biopsy; however, relative contraindications, such as those pertaining to patient tolerance of general anesthesia or sedation, may exist.
Thrombocytopenia is of limited concern as a contraindication for the procedure since hemorrhage into the confined marrow space is usually self-limiting; however, soft tissue trauma during access to bone should be carefully minimized in animals with thrombocytopenia or coagulopathy. In humans, non-major bleeding occurred in 0.19% of marrow biopsies, and was linked to thrombocytopenia rather than anticoagulant therapy (Moore & Kotchekov, 2021). Reduced immune competency due to neutropenia warrants additional precaution to reduce potential bacterial exposure, but in most animals with persistent neutropenia, assessment of marrow is an essential component of establishing a diagnosis. The risk of bone fracture is considered low and should be minimized by the use of biopsy needles that are proportional to the size of the patient, and consideration of potential pre-existing bone structural abnormalities such as osteoporosis.
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