[Stann]

Is BMB important?

by Stann on Fri Nov 04, 2011 11:46 am

I have graphs depicting my Mspike, IGG and total protein etc. They appear to accurately reflect my treatment (and lack of treatment)
Isn't the bone marrow biopsy a redundant procedure? Isn't the blood work more accurate?
Stan, who is trying to avoid the next BMB

[Dr. Edward Libby]

Re: Is BMB important?

by Dr. Edward Libby on Fri Nov 04, 2011 7:01 pm

Bone marow biopsy is not routinely required to evaluate response to therapy unless a patient is on a research study OR if the patient does not have measurable levels of an m-spike at diagnosis. Some oncologists do routinely perfom followup marrows even in patients with measurable disease (by m-spike in blood) but this is not absolutely necessary.
Some later stage relapsed and refractory patients can go from having a measurable m-spike to not having one and for these patients as well the only way to evaluate their response and status is to perform a bone marrow biopsy.

[mlweezieclark@yahoo.com]

Re: Is BMB important?

by mlweezieclark@yahoo.com on Sat Nov 05, 2011 7:43 am

I had one BMD before I was diagnosed have had 3 MRI bone marrow scans I know there is a difference in the tests feel very comfortable with this protocol

[chinook9]

Re: Is BMB important?

by chinook9 on Sat Nov 05, 2011 9:54 am

An aside note mlweezie. I recommend you change your user name from what is apparently your e-mail address. There are nefarious characters who have computers scanning the internet looking for e-mail addresses. These addresses are then bundled and sold to spammers. I used my e-mail address as my user name on eBay a few years ago and I started getting a lot of spam. I changed my eBay name but it was too late. I still get lots of spam.

[Dr. Edward Libby]

Re: Is BMB important?

by Dr. Edward Libby on Mon Nov 07, 2011 11:55 am

Hello again Stann,

I want to clarify my answer regarding follow-up bone marrow biopsies. Of course all patients must have them at diagnosis.

In terms of follow up......obviously most of the time bone marrow biopsies are not done to routinely follow a patients progress. Otherwise we would get them every 1-3 months.

Fortunately, in general there is a good correlation between a patients myeloma protein levels in the blood and the amount of myeloma in the marrow. That is a very fortunate thing because marrow biopsies can be painful and not all patients tolerate them well. However, there are times when the oncologist wants/needs more information. There is no universally agreed upon schedule/time for getting follow-up bone marrow biopsies. A second marrow during or after treatment will help to confirm what the blood tests are showing. The decision to perform follow-up bone marrow biopsy is made according to the clinical situation and the oncologists best judgement.

If bone marrow biopsies are hard for you to tolerate (anxiety, pain etc) you are not alone. I would recommend that you talk to your hematologist/oncologist to see what medications could be given to decrease anxiety and pain during the procedure.

In addition to lidocaine, we often give patients a fentanyl "lollipop" (Actiq) and a small dose of oral Ativan for bone marrow biopsies. Many other similar medications/approaches can be used as well.

For some patients having surgical type procedures is intolerable due to anxiety and pain. For those patients conscious sedation can used. This is similar to the sedation given when a patient has a colonoscopy. With conscious sedation the patient generally feels little or no pain and has little memory of the procedure.

I am certain your oncologist wants you to be comfortable during a bone marrow biopsy so just let them know if you are not.

Thanks for asking this question !