I have found that an MPN specialist will want to do a BMB if only to have a baseline reading. Also if you have a heavy symptom load.
My platelets have always ranged between 530 and 680 but I had quite a lot of symptoms. I had my biopsy in March of this year. It wasn’t terrible. Not something I would want to do regularly though! Haha! You definitely want it done by someone who does them all day every day if you have one. I felt bruised enough to not be able to sleep on my back and I kept my back side away from my dogs for a day. It was found that I do have some mild scarring. I’m glad I had it done.

Good luck with whatever you decide!

Hello Pamela,
I had my first BMB in early 2011, shortly after I was first diagnosed with ET based on a routine CBC, which showed very high platelets (1.2 million). That one was done in my hematologist's office. The procedure was not painful, just a little uncomfortable. However I did have some lingering sensitivity for quite some time.

I had a second BMB in summer 2022, before I went off hydroxyurea, in order to get a read on any change in the bone marrow since my first BMB, such as an increase in fibrosis that can suggest progression to MF (there wasn't any). That procedure was performed at Stanford. There was not much to it from my perspective. Right after the BMB, my husband drove us home (a 9-hour trip) . After the first few days, I had no residual discomfort.

I just had a third BMB at Stanford last month, as part of an eligibility screening for a clinical trial at Stanford. This last one was more involved (and a bit more uncomfortable), because they took three extra samples for research purposes. Even so, it just took a few days for the brusing to heal and for me to feel good as new.

Here's a helpful site that might answer some questions.
Good luck!
https://my.clevelandclinic.org/health/diagnosti...

Bone Marrow Biopsy: What It Is, Procedure & Results

https://my.clevelandclinic.org/health/diagnostics/17735-bone-marrow-biopsy

Someone mentioned quinine lowers platelets. I think I’ll pick up some tonic water and give it a whirl! Bummer is, I found out after a little research that it causes A-fib. Proceed with caution! Not recommended if you're on blood thinners.

According to WHO criteria for diagnosing ET, you need to have a bone marrow biopsy. Only the blood tests are not enough, as higher platelets can be due to several myeloproliferative neoplasms, including primary myelofibrosis. In order to distinguish between ET and PMF, you need a bone marrow biopsy.
I know it sounds a bit much, but a bone marrow biopsy at diagnosis is good to have, both as a baseline of how your bone marrow looks (hematologist can use this BMB for comparison with future BMBs), and for the accuracy of the diagnosis.
I hope your BMB goes smoothly.

Ok cancel that😀