[MMdaughter]

Lymphoctye/WBC percentages

by MMdaughter on Wed Apr 03, 2013 4:01 pm

Do typical multiple myeloma WBC results, show only Lymphocytes percentages being low (below normal) with neutrophils and monophils being in the high region of normal range. Why aren't they all low? Red blood cells are low (below normal). Platelets are in low normal range.

Doesn't production of all cells become affected? Do you think more lymphocytes are becoming plasma cells? Or are fewer lymphocytes being made which would explain why my dad has a low percentage of plasma cells but a lot of bone damage?

Thanks!

[Dr. Adam Cohen]

Re: Lymphoctye/WBC percentages

by Dr. Adam Cohen on Thu Apr 04, 2013 9:26 pm

While some myeloma patients do have low white blood cell counts at diagnosis, this can vary from patient to patient, so I wouldn't say that there is a "typical" WBC count or profile. Often the lymphocytes are disproportionately lower compared to the other types of WBC, so the relative percentage of these other WBC (such as neutrophils or monocytes) goes up. The reasons for this aren't completely clear, but is reflective of the general immune dysfunction that can occur in myeloma. The percentage of plasma cells in the bone marrow doesn't necessarily correlate with the extent of bone lesions. Rather it's the underlying biology of the myeloma cells that likely determines if the disease is more likely to involve the bones, or cause kidney damage, or affect the blood counts. We're starting to learn more (e.g. through genomic profiling of myeloma cells) about what causes myeloma to behave differently in different patients, but we still don't have perfect predictors of this yet.