[Tjkroeger]

Plasma cells 9% in aspirate, 10-20% in core biopsy

by Tjkroeger on Sat Jul 08, 2017 6:23 am

Hi.

I do not post to many forums and I have been going through many doctor's visits while trying to determine the reason for high calcium. and determining the existence of a monoclonal protein. But, I have a question that someone can hopefully help me with.

Fast forward after many blood tests and now a bone marrow biopsy, can someone tell me exactly what the following statement means from my biopsy results:

"Plasma cells comprise 9% of cellularity by aspirate smear differential and immuno­histo­chemical analysis of core biopsy by CD138 immunostain shows a plasma cell percentage in the range of 10%-20%"

In reading a lot of the other posts I understand that the plasma percentage is an important piece of the puzzle, but not sure exactly what the above may indicate.

Sorry if this is a vague question. Thanks!

[Cheryl G]

Re: Plasma cells 9% in aspirate, 10-20% in core biopsy

by Cheryl G on Sun Jul 09, 2017 5:52 pm

Hi,

The plasma cell percentage in the aspirate and core biopsy are often different. This is something Dr. Voorhees explains in this forum post.

Technically, when it comes to deciding whether or not someone has MGUS, smoldering myeloma, or active multiple myeloma, the published criteria for a diagnosis say the following:

"Bone marrow plasma cell percentage should preferably be estimated from a core biopsy specimen; in case of a disparity between the aspirate and core biopsy, the highest value should be used."

You can find a description of the diagnostic criteria in the "Criteria" posts pinned to the top of the "Do I Have Multiple Myeloma?" section of the forum:

Good luck!

[Tjkroeger]

Re: Plasma cells 9% in aspirate, 10-20% in core biopsy

by Tjkroeger on Sun Jul 09, 2017 6:04 pm

Thank you! This is helpful.

[Tjkroeger]

Re: Plasma cells 9% in aspirate, 10-20% in core biopsy

by Tjkroeger on Thu Jul 20, 2017 9:37 am

Hi everyone,

Well, I didn't receive the news I wanted from my bone marrow biopsy, but it sounds like it could have been worse. According to my oncologist, I technically meet the requirements for active multiple myeloma, since my core biopsy showed between 10% and 20% plasma cells and I have high calcium. Actually, it was the high calcium that was found during routine blood work that caused us to go down the path to determine why.

All of that being said, after talking with the oncologist and based on the fact that I have no other symptoms currently and my skeletal survey looks good, we are in monitor mode and not going to do any treatment right now. I go back in a few months to get more blood work and see where things are at and will probably determine what schedule to be on for monitoring. Hopefully, will not progress.

Thanks!

P.S. Love this forum! it has been a wealth of knowledge during this process and allowed me to get real information without jumping to conclusions and worrying.