[Beacon Staff]

Weekly Poll - Plasma Cell % At Multiple Myeloma Diagnosis

by Beacon Staff on Wed Jun 11, 2014 10:53 am

This week's poll is about bone marrow plasma cell percentage levels at the time a person is diagnosed with multiple myeloma.

By definition, someone who is diagnosed with multiple myeloma should have a bone marrow plasma cell percentage of at least 10 percent. That is, a test of a sample of the person's bone marrow should reveal that, of the cells present in the sample, at least 10 percent are plasma cells.

There is a similar poll being run parallel to this one for people who have been diagnosed with smoldering myeloma (link to that poll).

There will not be a similar poll for people diagnosed with MGUS (monoclonal gammopathy of undetermined significance) because, by definition, the range of potential plasma cell per­cent­ages for MGUS is much more narrow (0 to less than 10 percent).

A few important clarifications about this week's poll:

First, this poll is for people who have been diagnosed with multiple myeloma -- that is, mye­lo­ma that is active (symptomatic), rather than smoldering.

(You can still answer this poll if you initially were diagnosed with smoldering myeloma that eventually progressed to symptomatic multiple myeloma. If that's the case, please respond to this poll based on the plasma cell percentage you had at the time of your symptomatic mye­lo­ma diagnosis. You also can respond to the accompanying poll question for smoldering myeloma based on your plasma cell percent­age when you were diagnosed with smoldering myeloma.)

Second, if you are a caregiver or family member of a multiple myeloma patient, feel free to answer on their behalf.

Third, different tests of the bone marrow yield different estimates of the plasma cell percent­age. If you were given different estimates of your plasma cell percentage at the time of your multiple myeloma diagnosis, please answer the poll using the highest percentage you were told.

Fourth, although a plasma cell percentage of at least 10 percent is considered a requirement for a multiple myeloma diagnosis, we are nevertheless allowing for answers of less than 10 percent. This is for those cases where someone may have been told they have multiple mye­loma even though they did not strictly meet the definition of the disease.

As always, feel free to post comments, thoughts, or feedback about this week's poll in the space below. They can be very useful to other readers.

[1World]

Re: Weekly Poll - Plasma Cell % At Multiple Myeloma Diagnosi

by 1World on Fri Jun 13, 2014 12:55 am

My percentage was 90 back in January of 2012. I underwent an autologous transplant in June of 2012 and was in near complete remission till the end of 2013 when plasmacytomas began appearing. One literally popped up in my neck while driving to Basking Ridge, NJ for treatment.

After that two different chemo protocols were tried and failed. At the end of May I had BDT-PACE treatment without the P. This seems to have been effective. However, I had to be hospitalized for a platelet transfusion and for neutropenic fever. The day after I was sent home I went into a-fib and was re-hospitalized. It was discovered via echo ultrasound that I now have an enlarged left atrium. It is believed the a-fib and enlarged heart chamber resulted from the BDT-ACE.

It was hoped that I would, possibly after another BDT-ACE cycle, have an allogeinic transplant. Frankly, at this point I'm wondering if I'll be healthy enough to undergo the transplant but I don't know what other options I have. My multiple myeloma is subtype IgA with translocation 4,14.

I have been eminently optimistic up till now. But now am a bit concerned.

[pinball]

Re: Weekly Poll - Plasma Cell % At Multiple Myeloma Diagnosi

by pinball on Sat Jul 05, 2014 3:47 pm

Hi, are these the percentages shown by immunochemistry or as counted by machine?

I've noticed that each of my BMB's that there's a very much lower % shown up front by machine count (smear) for instance 3% which I would think the machine acct would be more accurate opposed to a manual process (viewing it usually seems 200-300 cells).

After a visit with my local oncologist this week and he referred to the much lower at 3% machine count on my May 2013 BMB performed at a large research facility vs the immunochemistry 10% PC positive for CD1380 , CD56, CD117 I did some searching and found that machine counts are accurate in normal folks but those with a plasma cell dyscrasia condition it seens machine (plasma celk) counts are lower than the actual % and immunochemistry is more accurate.

Which type of result is everyone referred to for these polls? (Smear , clot , flow cytometry , immunochemistry)

Thanks

[Beacon Staff]

Re: Weekly Poll - Plasma Cell % At Multiple Myeloma Diagnosi

by Beacon Staff on Sat Jul 05, 2014 11:13 pm

Hi Pinball,

Thanks for your question.

As you'll note in both the poll question and the explanatory text, we did not specify which measure­ment technique should have been used to determine the value people selected in the poll.

We did this because, in our experience, most people are told their plasma cell percentage by their physician at or around the time of diagnosis.

Also, although we cannot say for certain what measure each physician chooses when reporting the plasma cell percentage to their patients, there seems to be a convention (see this posting by Dr. Jonathan Kaufman, a myeloma specialist who is one of the Beacon's Medical Advisors) to report the largest percentage found by the different measurement techniques.

[genk]

Re: Weekly Poll - Plasma Cell % At Multiple Myeloma Diagnosi

by genk on Wed Aug 06, 2014 10:52 am

70%

[aniram8979]

Re: Weekly Poll - Plasma Cell % At Multiple Myeloma Diagnosi

by aniram8979 on Fri Aug 15, 2014 10:04 pm

My husband was diagnosed in April 2014, and a bone marrow biopsy gave 36%. A more recent biopsy in July showed 5%! He underwent 3 cycles of Velcade and dex (60 mg every 8 days).