Hi, I've read a lot of articles that seem to say that a bone marrow biopsy isn't really necessary if you have certain blood test which don't show marked increase.
I have a faint monoclonal band in urine and 3 serum M spikes which are below 1. Also low, abnormal lamda/ kappa ratio. I've had immunofixation to confirm protein in blood and urine. Can't think of any blood test that I haven't had done!
So why should I have a bone marrow biopsy? All comments will be appreciated! Thanks, Ginny
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Re: Bone marrow biopsy vs. blood work
Ginny,
It is understandable why patients wish to avoid an invasive test such as a bone marrow biopsy. While it is not necessary in all circumstances, it is typically performed along with a skeletal survey (X-rays of bones) if any of the following features are present:
An abnormal free light chain ratio, monoclonal (M) protein of non- immunoglobulin (Ig)G type such as IgA , IgM or IgD of any size, or if the size of M-spike is 1.5 g/ dL or greater even if a patient does not have frank myeloma-related features.
A stable immunoglobulin is certainly reassuring. However, in order to differentiate between monoclonal gammopathy of undetermined significance (MGUS) and asymptomatic multiple myeloma or other related disorders, unfortunately an initial bone marrow biopsy is required.
It is understandable why patients wish to avoid an invasive test such as a bone marrow biopsy. While it is not necessary in all circumstances, it is typically performed along with a skeletal survey (X-rays of bones) if any of the following features are present:
An abnormal free light chain ratio, monoclonal (M) protein of non- immunoglobulin (Ig)G type such as IgA , IgM or IgD of any size, or if the size of M-spike is 1.5 g/ dL or greater even if a patient does not have frank myeloma-related features.
A stable immunoglobulin is certainly reassuring. However, in order to differentiate between monoclonal gammopathy of undetermined significance (MGUS) and asymptomatic multiple myeloma or other related disorders, unfortunately an initial bone marrow biopsy is required.
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Dr. Prashant Kapoor - Name: Prashant Kapoor, M.D.
Beacon Medical Advisor
Re: Bone marrow biopsy vs. blood work
Thank you for your reply. The ratio is abnormal . And my immunoglobin has gone from 1474 to 1610 in 10 months. Are these the factors your talking about ?
Re: Bone marrow biopsy vs. blood work
Yes. Although the increase in immunoglobulin is not marked, an abnormal kappa/lambda ratio typically requires a bone marrow biopsy for further investigation.
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Dr. Prashant Kapoor - Name: Prashant Kapoor, M.D.
Beacon Medical Advisor
Re: Bone marrow biopsy vs. blood work
Thank you again for your patience in answering my questions , I appreciate it greatly!!
I have an appointment on Thursday but I'll call Monday to let them know that I will be agreeable to biopsy. Thanks again, Ginny
PS. Hope you truly understand how you are making a difference in people's lives here at the Forum
You are a blessing !!!
I have an appointment on Thursday but I'll call Monday to let them know that I will be agreeable to biopsy. Thanks again, Ginny
PS. Hope you truly understand how you are making a difference in people's lives here at the Forum
You are a blessing !!!
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