My diagnosis began with an unrelated health issue and checking to see if I was anemic. By standard definition (low red blood cell count), I was not. So when my oncologist gave my my diagnosis, I was confused.
He used the CRAB explanation of myeloma:
C = Calcium (elevated), R = Renal failure, A = Anemia, B = Bone lesions.
He went on to say my calcium was normal, there was no renal failure, and no bone lesions.
I was waiting for him to say "and you're not anemic". Much to my surprise, he explained that, though my rood blood cell and platelet counts were normal, anemia can also be defined as when the plasma cells take over the white blood cells. My white blood cell count is 3.3 and my bone marrow is made up of 25% plasma.
I wondered if anyone else has heard of anemia being defined that way.
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meganmcgrane - Name: Megan
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 31
Re: Anemia defined using plasma & white blood cell count?
Hi Megan,
I suspect that either your doctor misspoke, or you did not completely understand what he said, because anemia would not be measured based on the plasma cell percentage in your bone marrow, or based on your white blood cell count.
With anemia, the focus usually is on a patient's hemoglobin level when making a myeloma diagnosis. Usually the key question is whether it is below 10 g/dL. You can see the traditional criteria for a myeloma diagnosis (and the related diagnoses of smoldering myeloma and MGUS) in the Wikipedia article on multiple myeloma, particularly the diagnostic criteria section.
The criteria for diagnosis have been updated a bit recently, so that some patients formerly defined as having smoldering myeloma are now considered to have active (symptomatic) multiple myeloma. The changes in the criteria are described in this article:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
It may be that your doctor was focused on your hemoglobin level, which you may not have been told, or perhaps on your free light chain test results, which I'm not sure you've mentioned so far.
In any case, you definitely want to understand better the basis for your multiple myeloma diagnosis before you start treatment. You want to be very clear that your diagnosis is "active multiple myeloma", rather than smoldering multiple myeloma.
I hope this helps at least a bit. Let us know if you have any additional questions.
I suspect that either your doctor misspoke, or you did not completely understand what he said, because anemia would not be measured based on the plasma cell percentage in your bone marrow, or based on your white blood cell count.
With anemia, the focus usually is on a patient's hemoglobin level when making a myeloma diagnosis. Usually the key question is whether it is below 10 g/dL. You can see the traditional criteria for a myeloma diagnosis (and the related diagnoses of smoldering myeloma and MGUS) in the Wikipedia article on multiple myeloma, particularly the diagnostic criteria section.
The criteria for diagnosis have been updated a bit recently, so that some patients formerly defined as having smoldering myeloma are now considered to have active (symptomatic) multiple myeloma. The changes in the criteria are described in this article:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
It may be that your doctor was focused on your hemoglobin level, which you may not have been told, or perhaps on your free light chain test results, which I'm not sure you've mentioned so far.
In any case, you definitely want to understand better the basis for your multiple myeloma diagnosis before you start treatment. You want to be very clear that your diagnosis is "active multiple myeloma", rather than smoldering multiple myeloma.
I hope this helps at least a bit. Let us know if you have any additional questions.
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• Page 1 of 1