The bone marrow is where the blood cells are made.  A bone marrow biopsy involves taking a sample of bone marrow, usually from the back of the iliac crest (hip bone) or from the sternum (breastbone) to see how well the bone marrow is functioning, and if there are any abnormal cells in the bone marrow.  The procedure is performed in the Haematology Day Stay ward.  Nitrous oxide gas (Entonox) is used for pain relief.  Local anaesthetic is also given as an injection under the skin to numb the skin and surface of the bone.  You may have some soreness and bruising at the biopsy site afterwards, and may need to use paracetamol or other mild painkiller for a few days.

Red cell (blood) transfusions are given to treat symptomatic anaemia.  For haematology patients, these are given in the Haematology Day Stay unit.  Two to three units of red cells are usually given.  Each unit takes approximately two hours.  Before your transfusion, you will be asked to have a special blood test for crossmatching purposes, so that the correct blood can be issued.  If you have had a transfusion within the past three months, this must take place no greater than 72 hours prior to the transfusion.  If you have never received blood or if it was greater than three months ago, then the sample may be taken up to seven days prior to the transfusion.

These are given to patients with anaemia due to a deficiency of iron.  They are usually prescribed when a trial of iron tablets has been unsuccessful, either due to side effects or malabsorption.  The iron solution is given through an intravenous drip placed in your hand or arm.  The rest of the dose is then given over one to six hours, depending on the dose prescribed for you.  Possible side effects include headache, vomiting, muscle aches and flushing.  Rarely, more serious reactions may occur such as difficulty breathing, low blood pressure, and collapse.  Sometimes these reactions can be stopped by slowing down the rate of the infusion, or more rarely stopping it.  Very rarely, drugs may be given to treat the reaction.  Once the iron is replaced, the body starts making more red blood cells within the next two weeks. 

A lumbar puncture is a procedure to remove a small sample of cerebrospinal fluid (surrounds the spinal cord and brain) for analysis.  An injection of local anaesthetic is given, followed by the insertion of a thin needle into the spinal canal.  This is done to check for the presence of abnormal cells.  Sometimes an injection of a drug may be given at the same time (intrathecal chemotherapy). 

A wide range of chemotherapy is given in the Haematology Day Stay unit, for a number of different disorders.  Information leaflets specific to each regimen will be given to you prior to commencing chemotherapy.

Venesection refers to the removal of blood.  This procedure is performed for people who have too  many circulating red cells (polycythaemia) or iron overload (haemochromatosis).  It is similar to the procedure used for donating blood.  The frequency of venesections depends on the level of red cells or iron.  It may be weekly initially, until the level comes down, and then will be spaced out - sometimes to three or four times a year.  It is a lifelong process.