[kullybunnny1]

Re: Incomplete results on initial bone marrow biopsy

by kullybunnny1 on Wed Jan 28, 2015 6:22 am

Jim, that was indeed from my first biopsy, dated July 26, 2013. A separate analysis was per­formed by an outside lab on July 31, 2013. It stated the narrative provided and recommended an additional biopsy be performed. I guess that was confirmed by other findings.

As I said, I was not privy to the full results until last week and was concerned enough to seek advice from fellow Myeloma Beacon forum members. Looking back, I should have sought a second opinion, but at the time I was being pushed in a wheelchair, sleeping 18 hours a day, losing over 50 lbs (23 kg) in weight in two months, and suffering to the maximum the effects of this disease. I was both devastated and happy for the diagnosis.

Moving forward, I'm seeking to be a better advocate for my condition and continue to seek both advice and solace from fellow multiple myeloma patients.

Thanks, JimNY, for the thoughts on this matter.

Kully

[JimNY]

Re: Incomplete results on initial bone marrow biopsy

by JimNY on Wed Jan 28, 2015 1:54 pm

Hi Kully,

I'm stumped at this point. It seems really strange to me that you had such a high level of plasma cell involvement on your initial bone marrow biopsy, yet they were not able to get enough cells to successfully perform either FISH or metaphase cytogenetics.

I guess it can happen, if not for the simple reason that it does seem to have happened in your case, but it does seem weird to me.

I wish I could be of more help, but I can't offer come up with any additional advice at this point.

In any case, it's great that you're working to understand better your diagnosis and how you've responded to treatment. I'm sure it will be very helpful to you.

[Rneb]

Re: Incomplete results on initial bone marrow biopsy

by Rneb on Thu Feb 05, 2015 3:23 pm

Well, maybe a workup including baseline MRI's could help ?

New guidelines recently announced from IMWG

Good luck

---

Abstract

Purpose The aim of International Myeloma Working Group was to develop practical recommendations for the use of magnetic resonance imaging (MRI) in multiple myeloma (multiple myeloma).

Methods An interdisciplinary panel of clinical experts on multiple myeloma and myeloma bone disease developed recommendations for the value of MRI based on data published through March 2014.

Recommendations MRI has high sensitivity for the early detection of marrow infiltration by myeloma cells compared with other radiographic methods. Thus, MRI detects bone involvement in patients with myeloma much earlier than the myeloma-related bone destruction, with no radiation exposure. It is the gold standard for the imaging of axial skeleton, for the evaluation of painful lesions, and for distinguishing benign versus malignant osteoporotic vertebral fractures. MRI has the ability to detect spinal cord or nerve compression and presence of soft tissue masses, and it is recommended for the workup of solitary bone plasmacytoma. Regarding smoldering or asymptomatic myeloma, all patients should undergo whole-body MRI (WB-MRI; or spine and pelvic MRI if WB-MRI is not available), and if they have > one focal lesion of a diameter > 5 multiple myeloma, they should be considered to have symptomatic disease that requires therapy. In cases of equivocal small lesions, a second MRI should be performed after 3 to 6 months, and if there is progression on MRI, the patient should be treated as having symptomatic myeloma. MRI at diagnosis of symptomatic patients and after treatment (mainly after autologous stem-cell transplantation) provides prognostic information; however, to date, this does not change treatment selection.