Can someone help me to understand these bone marrow biopsy results? My specialist at UAMS didn't cover it, and I can't find what the values should be.
I would appreciate any info ya'll wanna share.
Thanks,
marv
Bone marrow aspirate and biopsy:
Normocellular bone marrow for age (35% cellularity); involved by plasma cell myeloma (20% plasma cells on aspirate; 5% on core biopsy)
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gmarv - Name: marvin
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: aug.2012
- Age at diagnosis: 57
Re: Understanding details of BMB report
Hi Marv,
The bone marrow report can be complicated but I think I can help you understand.
The first comment: "Normocellular bone marrow for age (35% cellularity)" is just to say that you have the normal amount of cells for your age. Newborns have 100% cellularity and then, as we age, some of the bone marrow is filled with fat rather than cells, so the percentage of cells goes down.
The next comment speaks to the myeloma. There are 2 components to the bone marrow test. The first is the "aspirate," where we extract the liquid portion of the bone marrow at one spot. The next is the "biopsy," where we take a piece of the bone.
The report states that, among the cells counted in the liquid sample, 20% were plasma cells.
On the biopsy, which is typically larger and often (but not always) more representative of the bone marrow in general, plasma cells accounted for only 5% of all the cells.
These 2 numbers can differ because myeloma is a patchy disease and the plasma cells can be dense in one area and relatively normal appearing in another area. So the aspirate sample may have come from a slightly denser area, but among the larger biopsy sample, there did not seem to be as many plasma cells.
Regardless, the true estimate of the number of plasma cells you have in your bone marrow is probably somewhere in between these two numbers. However, if the biopsy was a good specimen, again, it may be more reflective overall.
Hope this helps!
Heather Landau
The bone marrow report can be complicated but I think I can help you understand.
The first comment: "Normocellular bone marrow for age (35% cellularity)" is just to say that you have the normal amount of cells for your age. Newborns have 100% cellularity and then, as we age, some of the bone marrow is filled with fat rather than cells, so the percentage of cells goes down.
The next comment speaks to the myeloma. There are 2 components to the bone marrow test. The first is the "aspirate," where we extract the liquid portion of the bone marrow at one spot. The next is the "biopsy," where we take a piece of the bone.
The report states that, among the cells counted in the liquid sample, 20% were plasma cells.
On the biopsy, which is typically larger and often (but not always) more representative of the bone marrow in general, plasma cells accounted for only 5% of all the cells.
These 2 numbers can differ because myeloma is a patchy disease and the plasma cells can be dense in one area and relatively normal appearing in another area. So the aspirate sample may have come from a slightly denser area, but among the larger biopsy sample, there did not seem to be as many plasma cells.
Regardless, the true estimate of the number of plasma cells you have in your bone marrow is probably somewhere in between these two numbers. However, if the biopsy was a good specimen, again, it may be more reflective overall.
Hope this helps!
Heather Landau
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Dr. Heather Landau - Name: Heather Landau, M.D.
Beacon Medical Advisor
Re: Understanding details of BMB report
Thank you for this information, Dr. Landau.
There was a posting by Dr. Voorhees last year here in the forum that makes some of the same points you made about results from bone marrow aspirates and core biopsies. I found it once and thought it was useful, so I've kept it bookmarked. I'll do the same with this posting!
Dr. Voorhees said that the plasma cell percentage for the core biopsy is usually calculated based on a CD138 staining process. Is that correct?
The reason I ask is because I just want to make sure I correctly understand both of these postings.
There was a posting by Dr. Voorhees last year here in the forum that makes some of the same points you made about results from bone marrow aspirates and core biopsies. I found it once and thought it was useful, so I've kept it bookmarked. I'll do the same with this posting!
Dr. Voorhees said that the plasma cell percentage for the core biopsy is usually calculated based on a CD138 staining process. Is that correct?
The reason I ask is because I just want to make sure I correctly understand both of these postings.
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Jonah
Re: Understanding details of BMB report
Hi Jonah,
The bone marrow aspirate is comprised of the liquid portion of the bone marrow; the cells in this sample are spread on a slide which separates the cells and then they can be easily (relatively) counted without specific staining.
On the biopsy (where we take a piece of bone / bone marrow), the cells are not spread out. Therefore staining the cells with antibodies (i.e., CD 138) most sensitively highlights the plasma cells. See Figure 4 in the reference below for images.
SZ Al-Quran et al, "Assessment of bone marrow plasma cell infiltrates in multiple myeloma: the added value of CD138 immunohistochemistry," Human Pathology, Volume 38, Issue 12, December 2007, Pages 1779–1787.
The bone marrow aspirate is comprised of the liquid portion of the bone marrow; the cells in this sample are spread on a slide which separates the cells and then they can be easily (relatively) counted without specific staining.
On the biopsy (where we take a piece of bone / bone marrow), the cells are not spread out. Therefore staining the cells with antibodies (i.e., CD 138) most sensitively highlights the plasma cells. See Figure 4 in the reference below for images.
SZ Al-Quran et al, "Assessment of bone marrow plasma cell infiltrates in multiple myeloma: the added value of CD138 immunohistochemistry," Human Pathology, Volume 38, Issue 12, December 2007, Pages 1779–1787.
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Dr. Heather Landau - Name: Heather Landau, M.D.
Beacon Medical Advisor
Re: Understanding details of BMB report
Dr. Landau,
Your response is much appreciated and your explanation does help.
marvin
Your response is much appreciated and your explanation does help.
marvin
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gmarv - Name: marvin
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: aug.2012
- Age at diagnosis: 57
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