My doctor said my bone marrow biopsy [BMB] showed 85% plasma cell monoclonal. That seems comparably higher to most of the BMB reports that I have read from other people.
Should I be concerned, or is that basically normal for a recent (4 week) diagnosis?
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
Re: Bone marrow plasma cell percentage = 85%; is that high?
I think it's pretty high from what I've read that other people have reported.
When I was diagnosed in June 2013, my plasma cell percentage was 80%. After 5 rounds of Velcade / Revlimid / dexamethasone (VRD), a bone marrow biopsy done about 6 months after diagnosis showed 0%, so the treatments worked very well for me. I would hope that they'd work that well for you too. I had another bone marrow biopsy about a year after that in Jan 2015 and it was 1-2%.
The readings can vary in the bone marrow from one place to another, so that might explain part of the reason for the high reading.
When I was diagnosed in June 2013, my plasma cell percentage was 80%. After 5 rounds of Velcade / Revlimid / dexamethasone (VRD), a bone marrow biopsy done about 6 months after diagnosis showed 0%, so the treatments worked very well for me. I would hope that they'd work that well for you too. I had another bone marrow biopsy about a year after that in Jan 2015 and it was 1-2%.
The readings can vary in the bone marrow from one place to another, so that might explain part of the reason for the high reading.
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DallasGG - Name: Kent
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: 6/20/2013
- Age at diagnosis: 56
Re: Bone marrow plasma cell percentage = 85%; is that high?
On diagnosis, my plasma cell percentage was 14%. Apparently any percentage above 10% indicates myeloma.
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cdnirene - Name: Irene S
- Who do you know with myeloma?: me
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 66
Re: Bone marrow plasma cell percentage = 85%; is that high?
Hello Shari,
Welcome to the forum.
It's not clear to me from what you posted whether your plasma cell percentage of 85% was at diagnosis, or after a month of treatment. In either case, however, it is a relatively high percentage. This weekly poll the Beacon did last year asked people what their plasma cell percentage was at diagnosis, and only about a fifth had a percentage above 80%.
https://myelomabeacon.org/forum/weekly-poll-plasma-cell-percentage-multiple-myeloma-t3444.html
Now, having said that, I would also add that you shouldn't worry too much about the percentage. It is true that a high percentage suggests that the disease was relatively advanced when it was detected, and more advanced disease is often more difficult to treat. But, as someone already mentioned, you may have a high plasma cell percentage in the spot where you had your biopsy, but not much in other places. Myeloma is often a "patchy" disease -- it generally is not spread evenly in the bone marrow throughout your body.
Also, just because you have a high plasma cell percentage does not mean that your particular version of the disease won't respond well to treatment. Every myeloma patient is unique. Also, other factors, such as the chromosomal abnormalities that your myeloma cells have (which is a totally different subject), have more of an effect on how well the disease responds to treatment.
So just keep up with your treatment and see how things go. It can take several cycles to know how well the disease will respond to treatment.
Good luck!
Welcome to the forum.
It's not clear to me from what you posted whether your plasma cell percentage of 85% was at diagnosis, or after a month of treatment. In either case, however, it is a relatively high percentage. This weekly poll the Beacon did last year asked people what their plasma cell percentage was at diagnosis, and only about a fifth had a percentage above 80%.
https://myelomabeacon.org/forum/weekly-poll-plasma-cell-percentage-multiple-myeloma-t3444.html
Now, having said that, I would also add that you shouldn't worry too much about the percentage. It is true that a high percentage suggests that the disease was relatively advanced when it was detected, and more advanced disease is often more difficult to treat. But, as someone already mentioned, you may have a high plasma cell percentage in the spot where you had your biopsy, but not much in other places. Myeloma is often a "patchy" disease -- it generally is not spread evenly in the bone marrow throughout your body.
Also, just because you have a high plasma cell percentage does not mean that your particular version of the disease won't respond well to treatment. Every myeloma patient is unique. Also, other factors, such as the chromosomal abnormalities that your myeloma cells have (which is a totally different subject), have more of an effect on how well the disease responds to treatment.
So just keep up with your treatment and see how things go. It can take several cycles to know how well the disease will respond to treatment.
Good luck!
Re: Bone marrow plasma cell percentage = 85%; is that high?
Shari, my husband was at 90% when he was diagnosed in April. He is at week 6 of his treatments (VRD) and is doing well. He has non-secretory multiple myeloma and will have to get another bone biopsy to determine how well the treatments are doing. His doctor wants him to do the SCT once his treatments are done. Hang in there. You are not alone.
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Blue58 - Name: Blue58
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 57
Re: Bone marrow plasma cell percentage = 85%; is that high?
Wow, thank you to everyone who responded to my question. Yes, the 85% bone marrow plasma cell was at diagnosis. I must say being in the fifth percentile of people polled with high cell percentage is a bit discouraging, Cheryl G, but thanks for the information.
Dallas GG, did you have the SCT treatment after you completed the VRD cycles?
Much like Blue58, my doctor is encouraging me to have SCT procedure after 3 or 4 cycles. I don't think I am taking the Revilind but I know I have dex, Velcade injections, and Cytoxan [cyclophosphamide] weekly.
I am really grateful for the Beacon forum. I am learning a lot about this disease, and I am able to cope a little better.
Dallas GG, did you have the SCT treatment after you completed the VRD cycles?
Much like Blue58, my doctor is encouraging me to have SCT procedure after 3 or 4 cycles. I don't think I am taking the Revilind but I know I have dex, Velcade injections, and Cytoxan [cyclophosphamide] weekly.
I am really grateful for the Beacon forum. I am learning a lot about this disease, and I am able to cope a little better.
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
Re: Bone marrow plasma cell percentage = 85%; is that high?
Shari,
Ah, so you are on Cytoxan as well. If that is the case, you are on a multiple myeloma drug "cocktail" known as CyBorD (pronounced "Sigh-Bore-D"). CyBorD is a fairly common multiple myeloma treatment regimen.
Ah, so you are on Cytoxan as well. If that is the case, you are on a multiple myeloma drug "cocktail" known as CyBorD (pronounced "Sigh-Bore-D"). CyBorD is a fairly common multiple myeloma treatment regimen.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Bone marrow plasma cell percentage = 85%; is that high?
Shari asked:
Shari, yes I had an SCT about 2-3 months after my 5 cycles of VRD was completed. It's difficult to tell whether it made any difference, because my M-spike was zero and the bone marrow biopsy right before the transplant showed 0% bone marrow plasma cells.
It's been 14 months since my transplant and I still have a zero M-spike. I'm taking low dose Revlimid and dexamethasone for maintenance treatments right now.
I decided to go ahead with the transplant because I reasoned that I only get one chance to do an upfront transplant. Some experts believe that an upfront transplant improves progression-free and overall survival. There are other experts that believe that drug treatments alone can give the same advantages. It's a difficult decision for a multiple myeloma patient to make with the varying views on whether to do the transplant or not. Here's an interesting article that discusses both views:
"Experts Debate the Need for Upfront vs Late Stem Cell Transplant in Multiple Myeloma," The ASCO Post, Nov 1, 2014 (full text of article) (related Beacon forum discussion about the debate)
Good luck to you!
Dallas GG, did you have the SCT treatment after you completed the VRD cycles?"
Shari, yes I had an SCT about 2-3 months after my 5 cycles of VRD was completed. It's difficult to tell whether it made any difference, because my M-spike was zero and the bone marrow biopsy right before the transplant showed 0% bone marrow plasma cells.
It's been 14 months since my transplant and I still have a zero M-spike. I'm taking low dose Revlimid and dexamethasone for maintenance treatments right now.
I decided to go ahead with the transplant because I reasoned that I only get one chance to do an upfront transplant. Some experts believe that an upfront transplant improves progression-free and overall survival. There are other experts that believe that drug treatments alone can give the same advantages. It's a difficult decision for a multiple myeloma patient to make with the varying views on whether to do the transplant or not. Here's an interesting article that discusses both views:
"Experts Debate the Need for Upfront vs Late Stem Cell Transplant in Multiple Myeloma," The ASCO Post, Nov 1, 2014 (full text of article) (related Beacon forum discussion about the debate)
Good luck to you!
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DallasGG - Name: Kent
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: 6/20/2013
- Age at diagnosis: 56
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