direct removal of a small amount (about 1–5 millilitres) of bone marrow by suction through a hollow needle. The needle is usually inserted into the posterior iliac crest of the hip bone in adults and into the upper part of the tibia, the inner, larger bone of the lower leg, in children. Sternal (sternum) bone marrow aspirations are infrequent in modern clinical practice because of risk of injury to the heart, lungs, and great vessels in the chest. The necessity for a bone marrow aspiration is ordinarily based on previous blood studies and is particularly useful in providing information on various stages of maturation and production of blood cells. Disorders in which bone marrow examination is of special diagnostic value include leukemia, multiple myeloma, Gaucher disease, Niemann-Pick disease, and unusual cases of macrocytic and microcytic anemia. Metastatic spread of malignant cells from other organs to the bone marrow may be verified by bone marrow aspiration.