I recently had a bone marrow biopsy and could use some help interpreting these results:
1. hypercellular marrow with cellularity of up to 90%
2. A large number of plasma cells (by core biopsy 70 %)
3. Sheets of lambda restricted plasma cells, numerous atypical forms; plasma cells are lambda restricted
4. Triineage hematopoisis
5. Reticulin fibrosis
My hemoglobin has been dropping over the past 3 weeks from 10.4 to 10, resulting in a change from asymptomatic to symptomatic.
From the reading I've done, it sounds like this is adding up to a poor prognosis. If anyone can explain any of these findings, I'd be very grateful.
I'm not sure yet where I'll be treated. Do these results mean I'm high risk?
Thank you for any information that will help me understand what I'm facing.
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Re: Help interpreting bone marrow biopsy results
Well, you do have a high plasma cell percentage at 70% (normal is less than 5%) and you are right on the edge of being anemic by mm-standards (hemaglobin < 10g/dL), so it is good you are seeking treatment. You have lambda-type multiple myeloma. You can tell what your involved companion immunogloublin type is by seeing which one of your immunoglobulins is greatly elevated on your blood lab tests (it will likely be the IgG or IgA). Once you know that, you can tell if you are IgG-Lambda or IgA-Lambda or some other variation such as light-chain restricted, etc.
I really can't comment on items #4 and #5.
A couple of things.
None of this means a poor prognosis. Based on on what you say here, you could very well respond just great to treatment and could live a long life.
In order to sort out what your level of risk is, you would need to know your cytogenetic results (tells you if you have any genetic mutations associated with the disease) from your FISH and genetic tests. These tests were hopefully done when you had a bone marrow biopsy. Your doctor should be able to tell you which (if any) genetic mutations you have from those test results. When you know which mutations (if any) you have, you can use the mSMART guidelines to help determine your risk level. http://www.msmart.org/newly%20diagnosed%20myeloma.pdf
I think you already asked in an earlier thread what multiple myeloma centers of excellence are close to you. The most important thing you can be doing is getting hooked up with a top multiple myeloma specialist.
After you get hooked up with a specialist, the next big question you will need to answer is will you choose a transplant route or a drug-only route for treatment.
Best of luck to you.
I really can't comment on items #4 and #5.
A couple of things.
None of this means a poor prognosis. Based on on what you say here, you could very well respond just great to treatment and could live a long life.
In order to sort out what your level of risk is, you would need to know your cytogenetic results (tells you if you have any genetic mutations associated with the disease) from your FISH and genetic tests. These tests were hopefully done when you had a bone marrow biopsy. Your doctor should be able to tell you which (if any) genetic mutations you have from those test results. When you know which mutations (if any) you have, you can use the mSMART guidelines to help determine your risk level. http://www.msmart.org/newly%20diagnosed%20myeloma.pdf
I think you already asked in an earlier thread what multiple myeloma centers of excellence are close to you. The most important thing you can be doing is getting hooked up with a top multiple myeloma specialist.
After you get hooked up with a specialist, the next big question you will need to answer is will you choose a transplant route or a drug-only route for treatment.
Best of luck to you.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Help interpreting bone marrow biopsy results
Multibilly's response is very good.
Your risk status is defined by the FISH tests on the bone marrow or another test that is sometimes done called the MyPRS test. The thing to remember is that these are prognostic tests when applied to a large group of patients and do not necessarily fit individuals.
The fibrosis may or may not be related to the myeloma. It can certainly be associated (particularly if osteosclerosis is a component of your disease)
Your risk status is defined by the FISH tests on the bone marrow or another test that is sometimes done called the MyPRS test. The thing to remember is that these are prognostic tests when applied to a large group of patients and do not necessarily fit individuals.
The fibrosis may or may not be related to the myeloma. It can certainly be associated (particularly if osteosclerosis is a component of your disease)
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Help interpreting bone marrow biopsy results
Thank you, both, for your reply. I am IgG Lambda if that makes any difference.
I really appreciate your help.
One other question I'm struggling with: an appointment with my first choice doctor is not available for a month. Should I go with my 2nd or 3rd choice in order to be seen in just over a week? How critical is it to begin treatment immediately? My M protein is 2.7.
Again, thanks for all the helpful responses.
I really appreciate your help.
One other question I'm struggling with: an appointment with my first choice doctor is not available for a month. Should I go with my 2nd or 3rd choice in order to be seen in just over a week? How critical is it to begin treatment immediately? My M protein is 2.7.
Again, thanks for all the helpful responses.
4 posts
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