[weshipp]

Bone marrow biopsy negative - what is chance of cancer?

by weshipp on Wed Apr 22, 2015 3:49 pm

I had both a bone marrow biopsy and bone marrow aspiration done in May 2014 to test for cancers of the blood or bone marrow, including leukemias, lymphomas, and multiple myeloma.

Both came back negative and were sent to the Mayo Clinic to clear the possibility of amy­loid­osis, which they did. I was told I just had cloning cells in my lambda light chain of IgA, which were at 2,300, and I should get a blood test every 6 months to make sure there are no changes.

My questions are:

1. What is the likelihood that cancer could form in 2015?
2. Is there a period of time where you are cleared of cancer to develop?
3. Could you be okay for a year and than a year later something develop?

[Multibilly]

Re: Bone marrow biopsy negative - what is chance of cancer?

by Multibilly on Wed Apr 22, 2015 6:09 pm

Hi Weshipp,

Welcome to the forum.

I want to make sure I understand this correctly.

You had a bone marrow biopsy in May2014, which showed no signs of multiple myeloma. I assume you must have had some blood tests done before that bone marrow biopsy. Were there any signs of monoclonal protein in your blood tests at that time? (This would show up on you serum electrophoresis [SPEP], immunofixation [IFE] and free light chain tests).

Then, more recently you had some more blood tests done at the Mayo Clinic and those tests definitely do show some monoclonal proteins, right? Is the value of "2300" something you got from your serum protein electrophoresis (SPEP) test? What are the units of measure for that number and what is the accompanying description that goes with that value of 2300?

Did the Mayo Clinic also run a free light chain assay? Do you know those results?

Lastly, did the doctor at the Mayo give you a diagnosis such as monoclonal gammopathy of unknown significance (MGUS) or smoldering multiple myeloma?

[JPC]

Re: Bone marrow biopsy negative - what is chance of cancer?

by JPC on Thu Apr 23, 2015 5:38 pm

Good afternoon, Weshipp:

Having to start on the road of contemplating multiple myeloma and related diseases is certainly a bear at the outset in terms of understanding the landscape. Multibilly has asked very good questions trying to zone in on specifically understanding your issues. I will, however, offer a very general answer to your question.

It sounds like you have had a negative diagnosis based on a BMB, but you are trying to diagnose some related issues (if you were referring to a post-induction BMB, the situation would be different and a bit more complicated). I recall having several discussions with doctors that multiple myeloma is a very slow growing disease. For most people who get the diagnosis, they have no idea how long they have been in the MGUS state, but based on the community of doctors who observe MGUS patients, the MGUS lasts for many years, 5 easy, and in some cases 10 or 20 years before it advanced to SMM and full blown multiple myeloma.

So it is rare to move from zero to full blown multiple myeloma in less than a year. There is a small sub-group, however, who do have multiple myeloma that is relatively fast moving. The probability of this is small, but not zero. It generally correlates with very bad "cytogenetics". The test for this is called the "FISH" test.

People who have asymptomatic MGUS or (SMM) do have measurable myeloma based on the BMB, but have no symptoms. They can, however, get the FISH test on the small amount of multiple myeloma in the bone marrow, and get some idea of future risk. You, however, were completely negative. You could not get the FISH test done.

So the bottom line is that the odds are low for multiple myeloma based on what you mentioned, but not com­pletely outside of the realm of possibility.

Best of luck as you work with your doctors on your diagnosis. Regards,