Has any one been diagnosed or researched how circulating PBSC's affect diagnosis and survival in multiple myeloma?
I think I asked this wrong and I apologize, What I was looking for is circulating plasma cell events ... at least I think that is what I am looking for. Not sure if it is related at all to nucleated RBC's? I do know the only thing I can find on redirects back to plasma cell leukemia, which is not the case. I have been stuck on the meaning of this for quite some time. Should ask the doctor, right? I just like to research before I ask.
I had this and required additional chemo before stem cell but can' t seem to figure out what if anything about it. Is it a bad prognosis, will it come back? How does this play into over all survival?
Thanks!
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Re: Circulating plasma cells and prognosis
Hi Poontzy,
I think you're going to have to clarify a bit more exactly what you're asking. Perhaps you can explain what exactly you were "diagnosed with", or told, that led you to ask your the question.
The reason we're asking for a clarification is because it seems like you could be getting at two very different things.
The one possibility is that you're asking what it would mean if it took longer for you to harvest enough stem cell cells (PBSCs) for use in a potential autologous (own) stem cell transplant. Sometimes, to help stimulate the production of additional stem cells, patients are given cyclophosphamide (Cytoxan), which is also used to treat myeloma. Another drug that is also given to help stimulate stem cell production for collection is Mozobil (plerixafor).
The other possibility is that your physicians may have found elevated levels of what are known as circulating clonal plasma cells in your blood after your diagnosis. There is research that indicates that the higher the level of these plasma cells in the blood after diagnosis, the more challenging a patient's disease will be to treat. See, for example, this abstract from the recent ASH meeting:
https://myelomabeacon.org/resources/mtgs/ash2013/abs/1842/
If there are extremely high levels of clonal plasma cells in the blood at diagnosis, then the disease is no longer multiple myeloma, but (primary) plasma cell leukemia.
If you can help us clarify your question, we -- or others here in the forum -- may be able to offer some additional information that might be helpful to you.
I think you're going to have to clarify a bit more exactly what you're asking. Perhaps you can explain what exactly you were "diagnosed with", or told, that led you to ask your the question.
The reason we're asking for a clarification is because it seems like you could be getting at two very different things.
The one possibility is that you're asking what it would mean if it took longer for you to harvest enough stem cell cells (PBSCs) for use in a potential autologous (own) stem cell transplant. Sometimes, to help stimulate the production of additional stem cells, patients are given cyclophosphamide (Cytoxan), which is also used to treat myeloma. Another drug that is also given to help stimulate stem cell production for collection is Mozobil (plerixafor).
The other possibility is that your physicians may have found elevated levels of what are known as circulating clonal plasma cells in your blood after your diagnosis. There is research that indicates that the higher the level of these plasma cells in the blood after diagnosis, the more challenging a patient's disease will be to treat. See, for example, this abstract from the recent ASH meeting:
https://myelomabeacon.org/resources/mtgs/ash2013/abs/1842/
If there are extremely high levels of clonal plasma cells in the blood at diagnosis, then the disease is no longer multiple myeloma, but (primary) plasma cell leukemia.
If you can help us clarify your question, we -- or others here in the forum -- may be able to offer some additional information that might be helpful to you.
Re: Circulating plasma cells and prognosis
It generally depends upon how many or the percentage of peripheral blood plasma cells that determines a prognostic factor. If you have more than 2000 (sometimes listed as 2.0 on a CBC) plasma cells in the peripheral blood (or if there are less than 10000 WBC, then 20% of the white blood cells) that defines a plasma cell leukemia. That has a much poorer prognosis than multiple myeloma.
There is not much in the medical literature to define prognosis in other subsets of patients with lower numbers of circulating plasma cells. Although my personal experience is that the higher the number of circulating plasma cells, the more agressive the myeloma.
There is not much in the medical literature to define prognosis in other subsets of patients with lower numbers of circulating plasma cells. Although my personal experience is that the higher the number of circulating plasma cells, the more agressive the myeloma.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Circulating plasma cells and prognosis
Thank you! It was circulating clonal plasma cells and the abstract you provided was exactly what I was looking for as I had 462 events per 150,000. Thanks again
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