A bone marrow biopsy technique suitable for use in neonates

Thrombocytopenia and neutropenia are common among neonates in intensive car e units. Bone marrow aspirations are sometimes performed as part of their e valuation. However, marrow biopsies have not been reported from living neon ates. Since architecture and cellularity cannot generally be accurately ass essed from marrow aspirates, we devised a biopsy technique which we success fully applied to five cytopenic neonates (three with severe persistent thro mbocytopenia and two with idiopathic neutropenia). This technique used a 19 gauge, half-inch Osgood needle to obtain bone marrow clots from the tibias of small preterm neonates which enabled the assessment of marrow cellulari ty and architecture. On the basis of our initial experience we have ceased using the traditional bone marrow aspiration technique in neonates and now use this technique exclusively.