[1MYMARY1]

Bone Marrow Biopsy

by 1MYMARY1 on Thu Jun 13, 2013 10:44 am

I have just received a diagnosis of MGUS. Based on the following lab results, would you suggest a Bone Marrow Biopsy:

WBC 8.1
RBC 3.9
B12 949.1
Folate >20.0
Vitamin D 21.1
Iron Normal
Calcium 10.8
B-2 Microglobulin 2.42 mg/L
Kidney ESR 15
Macrocytic Anemia

M-Spike .41 g/dL
IgG Lambda in the gamma region as seen on IFE
Kappa Free Light Chains 21.9 mg/L
Lambda Free Ligh Chains 13.5 mg/L
Kappa/Lambda Free Ratio 1.16
No Bone Lesions on X-Rays

I am 66 years old and also have Type 2 Diabetes and Ischemic Heart Disease

[Dianem]

Re: Bone Marrow Biopsy

by Dianem on Thu Jun 13, 2013 2:05 pm

Hi - I would get a BMA only if the hemo-oncologist is recommending one. Not anemic, normal WBCs, low M spike, no lesions, etc. MGUS is common with auto-immunes and is symptomless. What is he/she recommending?
About a year and half ago, I was had my first M spike of 1.5 with a WBC of 4. Everything else was normal, but due to high spike and low WBC had a BMA which diagnosed me with IgG MGUS. My doctor said the most important preventative now is trying to keep bones strong in the event I progress to multiple myeloma. Are you taking bone density drugs? At my next appointment. we will discuss non-biophosphate drugs. Diane

[Dr. Jason Valent]

Re: Bone Marrow Biopsy

by Dr. Jason Valent on Thu Jun 13, 2013 2:09 pm

The RBC count is not the most helpful in anemia assessment. What is the hemoglobin or hematocrit?

If there is anemia, I will generally do a marrow biopsy but generally do not do bone marrow biopsies on all MGUS patients.

[Dianem]

Re: Bone Marrow Biopsy

by Dianem on Thu Jun 13, 2013 2:15 pm

Hi, me again - just read Dr. Valent's post and didn't mean to say 'not anemic' - thought normal iron was the same - sorry - Diane

[1MYMARY1]

Re: Bone Marrow Biopsy

by 1MYMARY1 on Thu Jun 13, 2013 2:26 pm

Sorry, my Hgb is 13.2 and my Hct is 29.8. Thanks for your time and assistance.

[Dr. Jason Valent]

Re: Bone Marrow Biopsy

by Dr. Jason Valent on Thu Jun 13, 2013 2:42 pm

With hemoglobin of 13.2, I would not encourage a bone marrow biopsy (although it is not wrong to do). It will not change management.

[1MyMary1]

Re: Bone Marrow Biopsy

by 1MyMary1 on Fri Jun 14, 2013 2:42 pm

Just a side note. I am a Vietnam veteran and there is research which indicates that Vietnam vets who develop MGUS are three times more likely to progress tp multiple myeloma than the general population. multiple myeloma is one of a group of diseases presumed to be caused by exposure to Agent Orange. This is one of the reasons that I will probably press for a BMB.

[rlt57413]

Re: Bone Marrow Biopsy

by rlt57413 on Wed Jul 31, 2013 12:06 am

I was just diagnosed with MGUS and had a bone marrow test, nerve conduct test, mri and so far everything is normal as well as all other blood tests. Now they want me to drink some stuff and get a ct scan with contrast to check for Lymphoma. I don't know if I really need that test. My hands and feet are burning 24/7 and I feel like I'm vibrating too. I feel like anyone with MGUS is a walking time bomb. Please correct me if I'm wrong!! I also have severe Osteoporosis and Osteoarthritis and Fibro and sciatica. I'm 58 and scared!!!
Vit D is 49 and I take 5000 D3 daily, I juice ginger everyday and juice veggies, apples about 4 times a week. My oncoligist says to get Plasmapheresis.......??????

I'm 58 and scared!!!

[Paulayl]

Re: Bone Marrow Biopsy

by Paulayl on Wed Jul 31, 2013 9:53 am

I was diagnosed with MGUS in 2011. My brother-in-law has multiple myeloma, so I was terrified. M-spike was .4. I have aggressive osteoporosis,and also had the PN in hands in feet. I had a skeletal survey, but no BMB. I read everything I could find, but had a real epiphany when I realized the odds of my MGUS progressing were low (1%/year?). I made a conscious decision not to worry! I am monitored every 6 months, and feel great. Stress and fear can make you feel bad!

[Multibilly]

Re: Bone Marrow Biopsy

by Multibilly on Wed Jul 31, 2013 11:07 am

rlt57413 wrote:
> I was just diagnosed with MGUS and had a bone marrow test, nerve conduct
> test, mri and so far everything is normal as well as all other blood tests.
> Now they want me to drink some stuff and get a ct scan with contrast to
> check for Lymphoma. I don't know if I really need that test. My hands and
> feet are burning 24/7 and I feel like I'm vibrating too. I feel like anyone
> with MGUS is a walking time bomb. Please correct me if I'm wrong!! I also
> have severe Osteoporosis and Osteoarthritis and Fibro and sciatica. I'm 58
> and scared!!!
> Vit D is 49 and I take 5000 D3 daily, I juice ginger everyday and juice
> veggies, apples about 4 times a week. My oncoligist says to get
> Plasmapheresis.......??????
>
> I'm 58 and scared!!!, w

I am smoldering and I totally relate with your angst. I thought taking D3 supplements was the right thing to do for this disease, but my calcium levels shot up when I did so. I became hypercalcemic as a result and thought I had entered the dreaded realm of "C" in CRAB. I then eliminated the D3 supplements altogether from my diet, including a multivitamin that contained D3. My calcium levels dropped accordingly. My vitamin D level was just fine to begin with, so I now realize that taking D3 supplements wasn't a great move on my part.