Hi
Got a bone marrow biopsy for a baseline. PET scan also normal .
Comment on the report: Marrow circularity is within normal limits and all elements are well represented. Plasma cells are borderline high in number. There are no abnormal lymphoid collections.Congo red stain is negative and reticulin stain normal.
Conclusion: No morphological or immunological evidence of any monoclonal plasma cell or lymphocyte disorder.
Wonder if anybody could tell me on what "Plasma cells are borderline high in number"" could mean?
P.S. - IgM 4 g/l (0.4 g/dL) MGUS patient
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Aussie - Name: Assue
- Who do you know with myeloma?: Nil
- When were you/they diagnosed?: 2015
- Age at diagnosis: 37
Re: "Plasma cells are borderline high in numbers" - meaning?
Hi Aussie,
If you go through your entire bone marrow biopsy report, there should be a bone marrow plasma cell (BMPC) percentage number listed somewhere. It's normal to have some number of plasma cells in your bone marrow. The normal BMPC % range is typically on the order of < 5%. My guess is that your BMPC % is close to 5% (and less than 10%), hence it's borderline high.
However, the most important thing is that no monoclonal plasma cells were visually observed (i.e. no morphological signs of monoclonal plasma cells), nor were any detected via immunological testing (i.e. no monoclonal plasma cells were detected when looking for telltale antigens on the plasma cell's surfaces via flow cytometry, staining, etc).
If you go through your entire bone marrow biopsy report, there should be a bone marrow plasma cell (BMPC) percentage number listed somewhere. It's normal to have some number of plasma cells in your bone marrow. The normal BMPC % range is typically on the order of < 5%. My guess is that your BMPC % is close to 5% (and less than 10%), hence it's borderline high.
However, the most important thing is that no monoclonal plasma cells were visually observed (i.e. no morphological signs of monoclonal plasma cells), nor were any detected via immunological testing (i.e. no monoclonal plasma cells were detected when looking for telltale antigens on the plasma cell's surfaces via flow cytometry, staining, etc).
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: "Plasma cells are borderline high in numbers" - meaning?
Not sure how you know all these things, but thanks.
Would a high plasma cell count make me more likely to get myeloma, given that I have IgM MGUS?
Would a high plasma cell count make me more likely to get myeloma, given that I have IgM MGUS?
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Aussie - Name: Assue
- Who do you know with myeloma?: Nil
- When were you/they diagnosed?: 2015
- Age at diagnosis: 37
Re: "Plasma cells are borderline high in numbers" - meaning?
First, you should find out what your bone marrow plasma cell percentage (BMPC%) actually is and talk to your doctor about it. The normal BMPC% for folks tends to vary quite a bit down in the single- digit range, so I wouldn't fret about it since no monoclonal plasma cells showed up on your particular test.
Also, keep in mind that these plasma cell percentage measurements aren't totally accurate. What they do to measure the bone marrow plasma cell percentage is just put a sample from your bone marrow procedure under a microscope and visually count the number of plasma cells that show up relative to the other cells on the slide. The measurement also depends on whether they were measuring the plasma cell percentage by looking at the bone marrow aspirate (the stuff they slurp out of your bone marrow when they first put the big needle into you) versus the bone marrow biopsy (the solid chunk of bone marrow they actually later extract when they are twisting that big needle and pulling it out of you).
The other variable is that myeloma and normal plasma cells aren't spread uniformly throughout one's bone marrow. So, you can potentially have different percentage readings depending on where the sample is taken, and monoclonal plasma cells may or may not appear on any given sample even if there are some monoclonal plasma cells lurking around somewhere in your bone marrow (which is certainly likely given that you have IgM MGUS).
If a rise in your bone marrow plasma cell percentage is accompanied by a sustained rise in your blood markers (i.e., IgM M-spike, involved serum free light chain, etc), then that might suggest you are progressing towards smoldering myeloma.
Also, keep in mind that these plasma cell percentage measurements aren't totally accurate. What they do to measure the bone marrow plasma cell percentage is just put a sample from your bone marrow procedure under a microscope and visually count the number of plasma cells that show up relative to the other cells on the slide. The measurement also depends on whether they were measuring the plasma cell percentage by looking at the bone marrow aspirate (the stuff they slurp out of your bone marrow when they first put the big needle into you) versus the bone marrow biopsy (the solid chunk of bone marrow they actually later extract when they are twisting that big needle and pulling it out of you).
The other variable is that myeloma and normal plasma cells aren't spread uniformly throughout one's bone marrow. So, you can potentially have different percentage readings depending on where the sample is taken, and monoclonal plasma cells may or may not appear on any given sample even if there are some monoclonal plasma cells lurking around somewhere in your bone marrow (which is certainly likely given that you have IgM MGUS).
If a rise in your bone marrow plasma cell percentage is accompanied by a sustained rise in your blood markers (i.e., IgM M-spike, involved serum free light chain, etc), then that might suggest you are progressing towards smoldering myeloma.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: "Plasma cells are borderline high in numbers" - meaning?
Thanks. Your explanation make sense, but my results not so much. My bone marrow plasma cell percentage is nil, but under trephine section there is just a observation that is was high. Sounds contradicting.
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Aussie - Name: Assue
- Who do you know with myeloma?: Nil
- When were you/they diagnosed?: 2015
- Age at diagnosis: 37
Re: "Plasma cells are borderline high in numbers" - meaning?
Remember what I said earlier:
"The measurement also depends on whether they were measuring the plasma cell percentage by looking at the bone marrow aspirate (the stuff they slurp out of your bone marrow when they first put the big needle into you) versus the bone marrow biopsy (the solid chunk of bone marrow they actually later extract when they are twisting that big needle and pulling it out of you)."
The "trephine biopsy" is the latter of the two tests I mentioned above. It's very common for there to be different BMPC % results for the aspirate and trephine analyses (which is why you want to make sure that both analyses are performed). The standard practice is to use the higher of the two BMPC percentage estimates when coming up with a final BMPC %.
"The measurement also depends on whether they were measuring the plasma cell percentage by looking at the bone marrow aspirate (the stuff they slurp out of your bone marrow when they first put the big needle into you) versus the bone marrow biopsy (the solid chunk of bone marrow they actually later extract when they are twisting that big needle and pulling it out of you)."
The "trephine biopsy" is the latter of the two tests I mentioned above. It's very common for there to be different BMPC % results for the aspirate and trephine analyses (which is why you want to make sure that both analyses are performed). The standard practice is to use the higher of the two BMPC percentage estimates when coming up with a final BMPC %.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: "Plasma cells are borderline high in numbers" - meaning?
Thank you. By having IgM MGUS,I always keep a lookout for any changes in my test as IgM is related to so many diseases.
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Aussie - Name: Assue
- Who do you know with myeloma?: Nil
- When were you/they diagnosed?: 2015
- Age at diagnosis: 37
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