J,
Thank you for the information. I look forward to hearing from your friend, but I won't be looking forward to multiple BMBs.
Ax
Forums
Re: Plasma cell percent - how accurate for diagnosis?
I'll send her a link to this discussion.
I should add that she had only trace monoclonal proteins and was originally diagnosed with MGUS, and it was not thought that her plasma cell dyscrasia had anything to do with her anemia because of her low bone marrow percentage on initial examination.
She had the bone marrow biopsy repeated twice within 3 months, and it jumped to 15% and 30% respectively, thereby confirming the diagnosis of multiple myeloma.
I do agree with your initial comments, "I'm sure I'm not the only patient that has presented with mixed findings that don't neatly fit into a pre-determined classification," because multiple myeloma has a heterogeneous clinical course and therefore requires a doctor that specializes in recognizing the unrecognizable and can autonomously make a clinical diagnosis.
My point is, don't rule it out until it is truly ruled out by a myeloma specialist
I should add that she had only trace monoclonal proteins and was originally diagnosed with MGUS, and it was not thought that her plasma cell dyscrasia had anything to do with her anemia because of her low bone marrow percentage on initial examination.
She had the bone marrow biopsy repeated twice within 3 months, and it jumped to 15% and 30% respectively, thereby confirming the diagnosis of multiple myeloma.
I do agree with your initial comments, "I'm sure I'm not the only patient that has presented with mixed findings that don't neatly fit into a pre-determined classification," because multiple myeloma has a heterogeneous clinical course and therefore requires a doctor that specializes in recognizing the unrecognizable and can autonomously make a clinical diagnosis.
My point is, don't rule it out until it is truly ruled out by a myeloma specialist
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jhorner - Name: Magpie
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 2013
- Age at diagnosis: 49
Re: Plasma cell percent - how accurate for diagnosis?
J,
Your point is well taken. I do have a Stanford fellowship trained hematopathologist locally and
as well as another one at Stanford. In addition, I also work with a plasma dyscrasia hem/onc specialist also at Stanford.
Your point is well taken. I do have a Stanford fellowship trained hematopathologist locally and
as well as another one at Stanford. In addition, I also work with a plasma dyscrasia hem/onc specialist also at Stanford.
-
Alex M - Name: Alex M
- Who do you know with myeloma?: No one
Re: Plasma cell percent - how accurate for diagnosis?
Hi Alex,
As you, I presented with anemia of unknown origin (I am the friend J Horner mentions). At presentation I also had low bone marrow plasma cell percentage. My bone marrow aspirate showed 7% PC (10-20% core). Other lab results included:
After 5 months from my initial presentation, I became transfusion dependent, requiring transfusions every two weeks.
At that point, the bone marrow biopsy revealed 30% in the core with profound erythroid hypoplasia - morphology compatible with pure red blood cell aplasia. My M-spike as well as my lambda levels were actually decreasing at this point
We decided we needed to do something and the only thing known for sure was that I had myeloma, so we decided to treat with Velcade and dex. Within 2 weeks of starting treatment, I was no longer transfusion dependent.
They believe the anemia to be secondary to an immune deregulation/autoimmunity in the context of myeloma.
I hope this helps. Best of luck and be well.
JD
As you, I presented with anemia of unknown origin (I am the friend J Horner mentions). At presentation I also had low bone marrow plasma cell percentage. My bone marrow aspirate showed 7% PC (10-20% core). Other lab results included:
- Hbg ~9
- Markedly hypercellular marrow at 95% with erythroid dysplasia and hyperplasia
- M spike 0.8 g/dl
- Lambda free light chains 115 mg/l
- Kappa free light chains 13.7 mg/l
- Trace light chains in urine
After 5 months from my initial presentation, I became transfusion dependent, requiring transfusions every two weeks.
At that point, the bone marrow biopsy revealed 30% in the core with profound erythroid hypoplasia - morphology compatible with pure red blood cell aplasia. My M-spike as well as my lambda levels were actually decreasing at this point
We decided we needed to do something and the only thing known for sure was that I had myeloma, so we decided to treat with Velcade and dex. Within 2 weeks of starting treatment, I was no longer transfusion dependent.
They believe the anemia to be secondary to an immune deregulation/autoimmunity in the context of myeloma.
I hope this helps. Best of luck and be well.
JD
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Jbodnar - Name: Jen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 2012
- Age at diagnosis: 45
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