[barbara1200]

What is the correct myeloma diagnosis for me?

by barbara1200 on Wed Mar 04, 2015 8:28 pm

Does anyone know if one has an M spike of 2.99 to 3.5 g/dL (29.9 to 35 g/L) when the M spike goes from being stable to progressing to active multiple myeloma?

I have been in this range since diagnosis a year ago but was diagnosed as multiple myeloma, as my bone marrow biopsy (BMB) showed I had 20 percent cells in the bone marrow. When they changed that to 60 percent, my diagnosis was not changed, but I seem to be in a smoldering position since I don't have any CRAB symptoms or bone lesions.

I was just wondering with the M spike what I should be looking for.

Thanks for any help on this.

[Toni]

Re: What is the correct myeloma diagnosis for me?

by Toni on Wed Mar 04, 2015 9:29 pm

You have an m-spike of 3-3.5 g/dl and 20-60% plasma cells in your bone marrow and you have not been diagnosed as myeloma?

So what type of scans have you had? Lesions? Is there any evidence of osteopenia / osteoporosis?

Others will need to chime in on this, but I thought those two indices alone would dictate a myeloma diagnosis?

[Mark K]

Re: What is the correct myeloma diagnosis for me?

by Mark K on Wed Mar 04, 2015 9:31 pm

barbara1200,

With the new criteria, 60 percent is considered a “myeloma defining events” even without any CRAB features:

Updated Definition of Multiple Myeloma

The revised IMWG criteria will allow, in addition to the classic CRAB features, the following three markers as “myeloma defining events” (MDEs).

• Sixty percent or greater clonal plasma cells on bone marrow examination
• Serum involved / uninvolved free light chain ratio of 100 or greater, provided the absolute level of the involved free light chain is at least 100 mg/L (a patient’s “involved” free light chain – either kappa or lambda – is the one that is above the normal reference range; the uninvolved light chain is the one that typically is in, or below, the normal range)
• More than one focal lesion on MRI that is at least 5 multiple myeloma or greater in size.

The presence of at least one of these markers will be considered sufficient for a diagnosis of multiple myeloma, regardless of the presence or absence of symptoms or CRAB features. Each of these markers has been shown in two or more independent studies to be associated with an approximately 80 percent or higher risk of developing myeloma-related organ damage within two years."

Source: SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders", The Myeloma Beacon, Oct 26, 2014.