Bone marrow aspiration and biopsy are usually not indicated in the evaluation of anemia and are only done when one of the following conditions is present: Unexplained anemia More than one cell lineage abnormality (ie, concurrent anemia and thrombocytopenia or leukopenia) Suspected primary bone marrow disorder (eg, leukemia, multiple myeloma, aplastic anemia, myelodysplastic syndrome, metastatic carcinoma, myelofibrosis) Bone Marrow Biopsy VIDEO Cytogenetic and molecular analyses can be done on aspirate material in hematopoietic or other tumors or in suspected congenital lesions of RBC precursors (eg, Fanconi anemia).