Regardless of what your lab may "ask for" in terms of bone marrow aspirations, as a clinician, I can assure you that you are most likely not getting it. In a diagnostic workup for leukemia, many mls of aspirate/blood mixture are often obtained because of the need for many studies. Typically the first pull will be used for smears, subsequent pulls for flow, cytogenetic, and potentially molecular studies. Total volumes can easily exceed 10 - 20 mL. Not a perfect world, but better for the patient than multiple sticks with an aspirating needle. Steven Gore Johns Hopkins Oncology Center
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