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The diagnosis of leukemia is based on the results of both blood and bone marrow tests, such as bone marrow aspiration and bone marrow biopsy.

Bone marrow aspiration: Before insertion of the bone marrow aspiration needle, the aspiration site is numbed with anesthesia. During this procedure, a sample of bone marrow cells is removed from the hip bone with a needle. Most people feel pressure as the needle is inserted and a few seconds of sharp pain when the bone marrow fluid is removed.

Bone marrow biopsy: With a bone marrow biopsy, a small piece of bone is removed. A biopsy may be slightly more painful, but only during the procedure.