[Ginny1]

Doctor says bone marrow biopsy not really needed

by Ginny1 on Wed Jun 18, 2014 8:35 pm

Hi,

I asked in another forum discussion whether I really needed to get a bone marrow biopsy based on my blood testing results.

Well, I went to the hem/onc doctor today. He said although he needs to tell me "legally" that I should have a biopsy, he doesn't think it's necessary . He says my my M-spikes are low at 0.5, 0.3 and 0.1 ( sometimes people have more than one), and only 2 of them are IgG. My lambda/ kappa ratio is low, 0.14, and bone scan is fine. One faint IgG band in urine.

However I've had intermittent heaviness in my feet, extreme thirst at times and lower back pain. Calcium increasing to 10.1 but still within normal range and creatinine is good too.

Questions:

Has anyone had foot problems or thirst problems long before anything showed up in tests?
Should a biopsy really be done with these low numbers?

[Dr. Edward Libby]

Re: Doctor says bone marrow biopsy not really needed

by Dr. Edward Libby on Wed Jun 18, 2014 8:51 pm

Hello Ginny,

If you do not have any of the CRAB criteria ... you do not have symptomatic multiple myeloma and in general you would not need to be treated. That will be true no matter what the bone marrow biopsy shows.

CRAB of course stands for high Calcium, Renal (kidney) problems, Anemia and Bone problems.

Whether or not a biopsy should be done is hard to say. It would confirm or deny that this is due to plasma cells in the marrow and tell you how high the plasma cells are in the marrow. Biopsies are quite safe and generally not too uncomfortable (although they can be hard for some patients). Other tests that could help to define what is going on include a bone marow MRI and Xrays of your major bones (skeletal survey).