[CD203]

Multiple myeloma and WBC counts - what's the connection?

by CD203 on Tue Jun 10, 2014 2:47 pm

Hi All,

Been looking around the web and this seems to be a good place for multiple myeloma questions.

Tomorrow I'll be going with my father (64) to see a surgeon to schedule removal of a small tumor from his left chest/breast area. My dad isn't the type to ask the right questions so I figure I'll take the liberty for him.

This whole process began around a month or so ago when he became very tired and developed back pain. Obviously, the tumor was found through a bone scan and he had a biopsy on it which determined it was cancerous.

My question relates specifically to WBC as I haven't been able to find good information on it anywhere.

During this process my father had 2 CBC drawn. The first gave a reading of 25,000 WBC/mcL and the second which was 2 weeks later came back 30,000 WBC/mcL.

My understanding suggests that the plasma WBC will multiply when multiple myeloma is present. This means that plasma = a type of WBC. Am I right so far?

Next, much of what I have read states that unlike leukemia, multiple myeloma causes a REDUCTION in WBC.

To me this seems like a contradiction.

[Dr. Ken Shain]

Re: Multiple myeloma and WBC counts - what's the connection?

by Dr. Ken Shain on Wed Jun 11, 2014 6:56 am

Multiple myeloma is a disease of plasma cells -- a kind of B cell (terminally differentiated B lymphocyte) that lives almost exclusively in the bone marrow and at relatively low numbers (about 1% of the marrow cellularity).

The role of plasma cells in normal immune function is to produced antibodies. Plasma cells do circulate in the peripheral blood (where the CBCs are checked), but are not seen in numbers that can actually be measured on a CBC.

Generally speaking, myeloma patients will have relatively normal white counts -- sometimes suppressed. The exceptions would be:

1) An aggressive form of myeloma called plasma cell leukemia in which the myeloma cells are no longer restricted to the bone marrow and are circulating in the peripheral blood. This can happen in a secondary manner, that is, as an "evolution" or transformation from multiple myeloma, or it can happen initially as "primary" (at diagnosis) plasma cell leukemia.

2) Under stressful conditions (e.g. infection, not mental stress), and

3) If on therapy, specifically with steroids.

In the latter two cases, the white count is elevated with normal neutrophils.

Other non-myelomatous diseases can be associated with increased WBCs - from malignant cells: CLL, MCL, AML, ALL to name a few.

Further infections and the existence of other tumors are can cause increased WBCs - with "normal" neutrophils.

Each of these conditions has a different outcome. Therefore, obviously, it will be important to find out what the increase WBCs are and biopsy of the mass.

Good luck to your father and keep us updated.

[Wayne K]

Re: Multiple myeloma and WBC counts - what's the connection?

by Wayne K on Wed Jun 11, 2014 12:41 pm

My WBC counts ran that and higher with CLL. I had a stem cell transplant for multiple myeloma and it put my CLL in remission and I now have low WBC counts. My WBC counts have dropped further with treatment.