Hi,
I have been diagnosed as having smoldering myeloma.
I have the following:
Monoclonal protein concentrate (paraprotein) 20 g/L (2.0 g/dL)
IgM - 0.24 g/L
igG - 8.97 g/L
Globulin - 44 g/L (this has been up for nearly 8-9 years now)
I have completed skeletal x-ray, MRI and bone biopsy, and blood tests.
I have been told that due to me having 40% plasma cells in bone biopsy that I have smoldering myeloma and there is a possibility I will be having active multiple myeloma within next 2 years.
My bone biposy states that..
Cellularity – Aparticulate, pluricellular sample and suboptimal sample. Allowing for low cellularity, there is a prominent population of plasma cells with some large and binucleate forms
Trephine Report: Tine 6 millimeter trephine, party bony and party crushed, small area of haematopoiesis appears hypercellular for age (70%) with a prominent interstitial infiltrate of plasma cells on a background of active trilineage haematopoiesis. CD138+ cells constitute approx. 40% of total cellularity. Reticulin grade 0/4 (MF - 0)
I am confused with what is CD138+ and some web site suggest the standard range is 40% +/-12. Can someone explain this jargon for me please?
By the way, this is the first time I have checked for M-protein even though my globulin level were high between 49-43) for the last 8-9 years, they never asked me to do any M-protein test, at this moment I do not have pain or any issues except this plasma cells being 40% as per my doctor.
Any help will be much appreciated
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Re: Meaning of CD138+ cell percentage?
Hi KRAJ,
Welcome to the forum.
CD138 is simply an antigen that is commonly found on the surface of plasma cells. They use this antigen marker to isolate and count your plasma cells via a method known as flow cytometry or by staining them with trephine and then manually determining their percentage of your bone marrow cellular makeup under a microscope. A normal bone marrow plasma cell count is between 0 - 5%.
I assume they also did a serum immunofixation test to tell you which of your immunoglobulins (IgG, IgA or IgM) is monoclonal and is returning the m-spike (monoclonal protein concentrate) value of 2 g/dL? I'm guessing it is likely your IgA immunoglobulin that has a monoclonal component?
In addition to your m-spike, you should also be tracking your serum free light chains (lambda and kappa), as well as your serum calcium, hemoglobin and creatinine levels. The latter three values can be found on your CBC and comprehensive metabolic panel tests.
Welcome to the forum.
CD138 is simply an antigen that is commonly found on the surface of plasma cells. They use this antigen marker to isolate and count your plasma cells via a method known as flow cytometry or by staining them with trephine and then manually determining their percentage of your bone marrow cellular makeup under a microscope. A normal bone marrow plasma cell count is between 0 - 5%.
I assume they also did a serum immunofixation test to tell you which of your immunoglobulins (IgG, IgA or IgM) is monoclonal and is returning the m-spike (monoclonal protein concentrate) value of 2 g/dL? I'm guessing it is likely your IgA immunoglobulin that has a monoclonal component?
In addition to your m-spike, you should also be tracking your serum free light chains (lambda and kappa), as well as your serum calcium, hemoglobin and creatinine levels. The latter three values can be found on your CBC and comprehensive metabolic panel tests.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Meaning of CD138+ cell percentage?
Thank you very much for your reply.
My IgA is 18 and serum free light chain is 8.74% (I am not sure if this is lambda or kappa - assume it is kappa as I was told I have IgA kappa myeloma).
Hemoglobin 141g/l
Creatinine 86 umol/L
My IgA is 18 and serum free light chain is 8.74% (I am not sure if this is lambda or kappa - assume it is kappa as I was told I have IgA kappa myeloma).
Hemoglobin 141g/l
Creatinine 86 umol/L
Re: Meaning of CD138+ cell percentage?
Serum free light chains or their ratio are not expressed as percentages. Are you sure the 8.74 figure wasn't a kappa-lambda ratio value with no units of measure, instead of a percentage? At some point, you want to find your lambda and kappa free light chain values on your lab printouts (which you should always ask for) and then take the ratio of kappa / lambda to track your free light chain ratio, as well as the kappa number.
With IgA myeloma, you also want to follow both your total IgA number and the M-spike value. For reasons I wont' go into here, the M-spike value in IgA patients can sometimes be inaccurate and overstated. So you need to do a reality check on the IgA M-spike number by keeping an eye on your total IgA number (which is made up of monoclonal IgA and normal, healthy IgA) and your free light chain numbers. You can also ask your specialist to occasionally run what is known as HevyLite test, which is very good at helping track disease progression in IgA myeloma patients.
With IgA myeloma, you also want to follow both your total IgA number and the M-spike value. For reasons I wont' go into here, the M-spike value in IgA patients can sometimes be inaccurate and overstated. So you need to do a reality check on the IgA M-spike number by keeping an eye on your total IgA number (which is made up of monoclonal IgA and normal, healthy IgA) and your free light chain numbers. You can also ask your specialist to occasionally run what is known as HevyLite test, which is very good at helping track disease progression in IgA myeloma patients.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Meaning of CD138+ cell percentage?
Thank you very much for your reply. I am seeing my specialist next week and will ask about the HevyLite test.
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