[Restlessrebel]

Bone marrow report - some questions

by Restlessrebel on Thu Feb 04, 2016 11:05 pm

Hi all,

I finally received my full bone mar­row report. I under­stand the majority of it, but I am pretty new to this part so a few things confused me. if you can weigh in, I would really appreciate it.

UNDER­STAND:

Diagnosis: Normocellular bone marrow (40%) is involved by a neoplastic plasma cell pop­u­la­tion comprising of 15%-20% of cellular marrow elements , expressing CD138, CD56, CyclinD1 and Lambda light chain restriction. Findings are diagnostic of plasma cell myeloma.

Cyclin D1 Positive in plasma cells
CD56 Positive in plasma cells
CD138 Positive in plasma cells
Kappa Light Chain Rare scattered positive
Lambda Light Chain Highlights majority of plasma cells

CONFUSED;

The bone marrow is hypercellular for age with the cellularity varying from 30% to 60% and overall estimated at 40%. I am 52 years young.

CD3 Monoclonal (LN10) Scattered positive in lymphoid cells
CD20 (L26) Scattered positive in lymphoid cells
Pax-5 Scattered positive in lymphoid cells

[jhorner]

Re: Bone marrow report - some questions

by jhorner on Tue Feb 16, 2016 12:57 pm

Hello Restless,

Your bone marrow biopsy results are almost exactly the same as mine with the exception that I am CD20 negative unfortunately. Cyclin D positive and CD56 positive I think are good things because there are targeted therapies that use this protein and antigen in therapeutic antibody treatments as a mediator.

There is a recent study that shows that t(11:14) translocation with CD20 responds better to drug therapy than without CD20. Do you know if you have any chromosomal translocations?

I still have not talked to my doctor about my bone marrow biopsy and cytogenetic results so I don't want to say too much because I too am largely in the dark about what this all means. Good Luck and keep us posted!

JBH

[pinball]

Re: Bone marrow report - some questions

by pinball on Mon Mar 14, 2016 11:12 am

My bone marrow biopsy report also included CD20+ - also noted in my report and related to CD20+ : "Small mature plasma cell morphology"

Searching around I've found that small mature plasma cell morphology is related to CD20+ as well as (11:14) translocation (which is noted in the previous post as having favorable outcomes to treatment).

Does your report happen to mention small mature plasma cell morphology anywhere as you are also CD20+? I can't really tell how common it is for small mature plasma cells to appear as well as CD20+ .

Here's a portion of my 2014 10% bone marrow plasma cell percentage report to compare (I'll have another bone marrow biopsy "soon"):

Interpretation:
Aberrant plasma cells detected, 91% of total plasma cells, consistent with plasma cell neoplasm. The aberrant plasma cells CD38+, CD138+, CD19(partial), CD20(+), CD28(-), CD56(-), CD117(+), cyto-Kappa(+), cyto-Lambda(-).

[Restlessrebel]

Re: Bone marrow report - some questions

by Restlessrebel on Mon Mar 14, 2016 11:38 pm

Hi JHorner and Pinball.

Thank you both for your replies. I will see my oncologist this coming Friday for my 3-month check­up, so I will ask about the questions the two of you posted.

I do not see "mature plasma cell morphology" wording in my 8 page report, but maybe I missed it somewhere.

The best to you both!

[pinball]

Re: Bone marrow report - some questions

by pinball on Wed Mar 16, 2016 11:53 am

Good luck with your upcoming appointment, Restlessrebel . I wouldn't worry much about CD20+ and small plasma cell morphology. I'll create a thread dedicated to more info at a later time so that the experts can chime in.

Just as FYI, here's portions of my 2014 bone marrow report that alluded to the appearance of small but mature plasma cells found in my marrow clot / smears (also linked my cells were CD20+) - If you didn't see anything similar on your report, then likely your samples didn't include such cells though you were CD20 positive.

BM Clot - description includes:

"Scattered small mature plasma cells noted"

Bone Marrow Smears - description includes:

"About 3% plasma cells are noted; small and mature"

[Restlessrebel]

Re: Bone marrow report - some questions

by Restlessrebel on Mon Mar 21, 2016 8:30 pm

Hi Jhorner and Pinball,

I met with my oncologist and he said that they are testing a drug right now that targets the cd56 and cd138. They are not offering to smoldering patients at this time from what I understand, but it is in trial for people who have relapsed on other drugs with full fledged multiple myeloma.

I am still not on any treatment as I do not have any symptoms. But will start Zometa once a month in a few days.

Take care.

[pinball]

Re: Bone marrow report - some questions

by pinball on Fri Mar 25, 2016 10:28 am

Great news, Restlessrebel, that your latest testing indicates you are CRAB free. Hopefully we will all smolder until a vaccine / cure is available.