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Re: Could I have multiple myeloma?
Thanks Multibilly. I've been reading non-stop trying to understand. It's all so foreign to me. You seem to know a lot about it, and I appreciate you explaining my questions!
Re: Could I have multiple myeloma?
Just had my appointment in Cleveland. Scheduled a bone marrow biopsy for Wednesday. Also doing the 24-hour urine test and more blood work. Really hoping for the best right now, but trying to prepare for if it's not so good news.
Re: Could I have multiple myeloma?
That's good to hear things are progressing on the diagnostic front. Bone marrow biopsy results are extremely difficult for anybody but a pathologist or multiple myeloma specialist to decipher. So make sure your specialist walks you through the entire bone marrow biopsy report and take lots of notes and ask for your own copy. You are specifically going to want to know what your bone marrow plasma cell percentage is and what, if any, adverse cytogenetics you might have that are related to your diagnosis. It will likely take at least a week or two to get all the bone marrow biopsy test results back. Good luck!
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Could I have multiple myeloma?
I will be sure to write everything down and get copies. I'm also having a full x-ray tomorrow. I would have had the bone marrow biopsy done yesterday, but I'm on Coumadin (warfarin), and they worried about the bleeding. So I had to stop that till after the test.
I have a follow up appointment next Wednesday so I'm hoping my results will be back by then!
Does all this sound like the normal diagnosis-related testing?
I have a follow up appointment next Wednesday so I'm hoping my results will be back by then!
Does all this sound like the normal diagnosis-related testing?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Could I have multiple myeloma?
So far I've gotten one blood test back. My beta-2 microglobulin. It is high at 2.8 mg/L. Not extremely high, but high nonetheless. Normal is 0.3-1.9 mg/l at my lab. Not sure if this means anything or not.
Also just had my bone marrow biopsy done and am waiting for my x-ray.
Ready to just put all this behind me. It helps to talk about it here because I've told no one yet really. Don't want to worry everyone unless there is a reason. Thanks for listening!
Also just had my bone marrow biopsy done and am waiting for my x-ray.
Ready to just put all this behind me. It helps to talk about it here because I've told no one yet really. Don't want to worry everyone unless there is a reason. Thanks for listening!
Re: Could I have multiple myeloma?
Personally, I wouldn't worry about your beta2 microglobulin (B2M) number at this level. B2M is a loose measure of tumor burden and it is used primarily for staging / prognostic purposes. The key B2M threshold for staging (provided one has a diagnosis of symptomatic multiple myeloma) is 3.5 mg/L, so you are well under that level.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Could I have multiple myeloma?
I think I have my blood work all messed up trying to use MyChart. I'm not sure those results were the right ones. I think I'd be better off letting my doctor explain everything on my next appointment. This is A LOT to take in!
Re: Could I have multiple myeloma?
Any idea of what all the results in this biopsy report could mean? I've tried to search but can't figure it out.
Any help would be greatly appreciated. Thanks!
FINAL DIAGNOSIS
Bone marrow, biopsy core, aspirate clot, touch imprint, aspirate and peripheral blood smears:
- Plasma cell neoplasm (kappa), representing approximately 30% of bone marrow cellularity.
- Cellular (30%, excluding plasmacells) bone marrow with trilineage hematopoiesis.
- See comment.
COMMENT:
The patient has a history of an M protein characterized as IgA kappa. The findings in this case consist of a monotypic kappa, IgA positive plasma cell population representing approximately 30% of total bone marrow cellularity.
In conclusion, the findings are diagnostic of a plasma cell neoplasm meeting the criteria for plasma cell myeloma. Further characterization of this lesion requires correlation with clinical, laboratory and radiologic findings. Conventional cytogenetic analysis may provide additional information.
PERIPHERAL BLOOD:
CBC (07/13/2016): WBC 6.6; Hgb 13.9; MCV 85.3; RDW 15.0; Pits 217
Differential (%): Segs 51, Lymphs 40, Monos 6, Eos 3, Baso 0, Other 0
Morphology/Interpretation: Unremarkable, rare circulating plasma cells.
BONE MARROW ASPIRATE:
Normal %
(0-2) 1 % Blasts
(1-5) 0 % Promyelo
(32-72) 36 % Myelos/Metas/Bands/Segs
(1-6) 1 % Eosinophils
(0-1) 0 % Basophils
(0-4) 0 % Monocytes
(13-37) 37 % Erythroid precursors
(7-23) 13 % Lymphocytes
(0-2) 12 % Plasma cells
Myeloid/Erythro (1.5-4): 1 Cells counted:500
Any help would be greatly appreciated. Thanks!
FINAL DIAGNOSIS
Bone marrow, biopsy core, aspirate clot, touch imprint, aspirate and peripheral blood smears:
- Plasma cell neoplasm (kappa), representing approximately 30% of bone marrow cellularity.
- Cellular (30%, excluding plasmacells) bone marrow with trilineage hematopoiesis.
- See comment.
COMMENT:
The patient has a history of an M protein characterized as IgA kappa. The findings in this case consist of a monotypic kappa, IgA positive plasma cell population representing approximately 30% of total bone marrow cellularity.
In conclusion, the findings are diagnostic of a plasma cell neoplasm meeting the criteria for plasma cell myeloma. Further characterization of this lesion requires correlation with clinical, laboratory and radiologic findings. Conventional cytogenetic analysis may provide additional information.
PERIPHERAL BLOOD:
CBC (07/13/2016): WBC 6.6; Hgb 13.9; MCV 85.3; RDW 15.0; Pits 217
Differential (%): Segs 51, Lymphs 40, Monos 6, Eos 3, Baso 0, Other 0
Morphology/Interpretation: Unremarkable, rare circulating plasma cells.
BONE MARROW ASPIRATE:
Normal %
(0-2) 1 % Blasts
(1-5) 0 % Promyelo
(32-72) 36 % Myelos/Metas/Bands/Segs
(1-6) 1 % Eosinophils
(0-1) 0 % Basophils
(0-4) 0 % Monocytes
(13-37) 37 % Erythroid precursors
(7-23) 13 % Lymphocytes
(0-2) 12 % Plasma cells
Myeloid/Erythro (1.5-4): 1 Cells counted:500
Re: Could I have multiple myeloma?
I'm not a doc, but the test result "a monotypic kappa, IgA positive plasma cell population representing approximately 30% of total bone marrow cellularity" would suggest smoldering myeloma in the absence of any CRAB symptoms (high calcium, renal insufficiency, anemia or bone issues such as lytic lesions).
Have you been imaged yet? If so, what kind of imaging did you have and what were the results? Imaging will tell you if you have any bone issues such as lytic or focal lesions.
When do you go go back to the Cleveland Clinic to discuss the results?
Have you been imaged yet? If so, what kind of imaging did you have and what were the results? Imaging will tell you if you have any bone issues such as lytic or focal lesions.
When do you go go back to the Cleveland Clinic to discuss the results?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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