[sukie]

M-spike threshold for bone marrow biopsy?

by sukie on Wed Feb 08, 2017 4:02 pm

Hi,

I've read quite a few posts and decided to become a member so I can keep up and learn more.

Some background:

• M-spike of 0.3 g/dL, which I know is very low.
• Slightly below normal RBC and a persistently low WBC.
• IgG is on the low side, ranging between 630-730. Last year had a number of wonky infections, so got an IgG infusion. Raised my IgG to 900+, helped the infections, but has since fallen back to 730.
• Calcium and kidney function tests are normal.
• Two skeletal x-rays taken a year apart show no lytic changes.

My hematologist says my M-spike is very low, so I don't need a bone marrow biopsy. I see here on the forum that many MGUS patients have had a bone marrow biopsy. Is there an M-spike value that indicates the need for one?

I should mention I also had a chin to pelvis CT scan and follow-up PET scan a year ago when there was a suspicious growth on my lung. It turned out to be inflammation / infection of unknown origin, not cancer thank goodness! So maybe I've been scanned enough and don't need the bone marrow biopsy?

Thanks so much for any thoughts.

[LuvHiking]

Re: M-spike threshold for bone marrow biopsy?

by LuvHiking on Tue Feb 14, 2017 2:30 pm

Welcome to the Forum!

You have a very low M-spike. Each hematologist is different in their wanting to conduct a bone marrow biopsy. Everything also depends upon the results and the trends in your other blood test results.

My wife had her first biopsy when her M-spike was 0.6 g/dL, but she had a very low white blood count with her neutrophils at 0.7. A year later, her M-spike was above 1.5 g/dL, and many other blood tests indicated that she was progressing toward a diagnosis of myeloma - increasing IgG kappa light chain values, increasing K/L ratio. The second bone marrow biopsy came back clean including her FISH panel. Her hematologist is now focused on a autoimmune diagnosis.

Along with your periodic M-spike changes, watch for changes outside of the normal ranges and the direction of the changes in your blood tests.