I'm so confused. Is it possible to be misdiagnosed with myeloma?
My mom was diagnosed with aggressive kappa light chain myeloma ... a lot of bone damage, etc.
After one round of VRD her urine is showing nothing -- no M spike, a normal kappa/lambda ratio, etc. -- like nothing out of the ordinary. even though her numbers were pretty bad only 6 weeks ago.
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Re: Multiple myeloma misdiagnosis - is it possible?
Hello from sunny Seattle,
Patients can have amazingly rapid improvements in their free light chains after 1-2 cycles of chemotherapy. It is unusual to see complete disappearance so quickly, but I also have recently seen this in a patient of mine. It is probably real and I'll bet the oncologist is surprised as well. Lets hope for a good recovery for your mother.
The next set of free light chains will tell know you for sure. I suspect it was not a misdiagnosis (especially if she had lytic bone lesions), but as I do not have all of her diagnostic information, I cannot be sure.
I wish you and your mother the best of luck in your battle with myeloma.
Patients can have amazingly rapid improvements in their free light chains after 1-2 cycles of chemotherapy. It is unusual to see complete disappearance so quickly, but I also have recently seen this in a patient of mine. It is probably real and I'll bet the oncologist is surprised as well. Lets hope for a good recovery for your mother.
The next set of free light chains will tell know you for sure. I suspect it was not a misdiagnosis (especially if she had lytic bone lesions), but as I do not have all of her diagnostic information, I cannot be sure.
I wish you and your mother the best of luck in your battle with myeloma.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Multiple myeloma misdiagnosis - is it possible?
Thanks Dr. Libby.
It's just beyond weird. Her FISH results were:
"An abnormal plasma cell population is identified, compromising 2.2% of the total cells."
Is it normal to have severe bone damage with such little myeloma detected? And it also came back as normal myeloma. However, the specimen was incomplete to detect for all chromosomes. Should another FISH be ordered?
It's just beyond weird. Her FISH results were:
"An abnormal plasma cell population is identified, compromising 2.2% of the total cells."
Is it normal to have severe bone damage with such little myeloma detected? And it also came back as normal myeloma. However, the specimen was incomplete to detect for all chromosomes. Should another FISH be ordered?
Re: Multiple myeloma misdiagnosis - is it possible?
Hello again,
In order to know the amount of plasma cells that your mother had at diagnosis you need to find the percentage by morphology. The amount detected by flow cytometry is generally much lower than the real (morphologic) number. This is a common mistake when trying to interpret a bone marow biopsy report. The flow cytometry is not what you want to know.
In the report, find the percentage of plasma cells in the core biopsy by morphology or by CD138 staining. CD138 is the gold standard to count plasma cells. FISH is not used to quantitate the amount of plasma cells.
In order to know the amount of plasma cells that your mother had at diagnosis you need to find the percentage by morphology. The amount detected by flow cytometry is generally much lower than the real (morphologic) number. This is a common mistake when trying to interpret a bone marow biopsy report. The flow cytometry is not what you want to know.
In the report, find the percentage of plasma cells in the core biopsy by morphology or by CD138 staining. CD138 is the gold standard to count plasma cells. FISH is not used to quantitate the amount of plasma cells.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
4 posts
• Page 1 of 1