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Polyclonal bone marrow
What is the meaning of bone marrow that has plasma cells 5-10% that are polyclonal?
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Polyclonal bone marrow
I should add there is NO light chain restriction they are 50% kappa / 50% lambda. The doctor says this makes the biopsy " inconclusive" There are no chromosome mutations on the FISH either. We are waiting on more testing just wondering if anyone else has had this type of biopsy result?
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Polyclonal bone marrow
I just wanted to check in and see if someone could weigh in on this. I spoke with a nurse and her explanation confused me more. She said it did not matter if the cells were monoclonal or polyclonal that having 5-10% plasma cells in the bone marrow even if they were NOT light chain restricted because they were 50% kapp and 50% lambda it still meant my husband was no longer in remission because they were over the 5% cut off??? Any insights PLEASE?
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Polyclonal bone marrow
Hi Blair,
I think you might be confusing the definitions for remission with the definitions for relapse. In your case, I think you are interested in the definition of relapse.
See Dr. Libby's comments on the definition for non-clinical RELAPSE:
https://myelomabeacon.org/forum/asymptomatic-relapse-post-stem-cell-transplant-t3009.html
If we are instead talking about the definition of REMISSION, my understanding is somewhat like what you heard from the nurse for the definition of "complete remission" (CR), BUT the plasma cell % must be < 5% on TWO BMB tests, not just one...and there needs to be no detectable M-spike in order to be considered a CR. In general, the presence of polyclonal cells is actually a good thing. But again, this last set of comments pertain to remission, not relapse.
As always, I'm not a doc, so an expert should really weigh in here.
I think you might be confusing the definitions for remission with the definitions for relapse. In your case, I think you are interested in the definition of relapse.
See Dr. Libby's comments on the definition for non-clinical RELAPSE:
https://myelomabeacon.org/forum/asymptomatic-relapse-post-stem-cell-transplant-t3009.html
If we are instead talking about the definition of REMISSION, my understanding is somewhat like what you heard from the nurse for the definition of "complete remission" (CR), BUT the plasma cell % must be < 5% on TWO BMB tests, not just one...and there needs to be no detectable M-spike in order to be considered a CR. In general, the presence of polyclonal cells is actually a good thing. But again, this last set of comments pertain to remission, not relapse.
As always, I'm not a doc, so an expert should really weigh in here.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Polyclonal bone marrow
Thanks Multibilly this information is helpful. I guess I'm confused by the difference in a monoclonal plasma cell versus a polyclonal plasma cell. I thought plasma cells needed to be monoclonal to be myeloma related? I was always under the impression that the plasma cells related to myeloma were monoclonal not polyclonal and over a certain percentage helped classify the stage. I guess I'm wrong about this
And any plasma cells over 5% on a BMB is BAD -- it doesn't matter if they are poly or monoclonal? Is that right?
And any plasma cells over 5% on a BMB is BAD -- it doesn't matter if they are poly or monoclonal? Is that right?
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Polyclonal bone marrow
Blair,
You are right that monoclonal plasma cells are the cells associated with multiple myeloma. But I don't feel qualified to comment further on the >5% question. Hopefully, somebody else will pick up from here.
You are right that monoclonal plasma cells are the cells associated with multiple myeloma. But I don't feel qualified to comment further on the >5% question. Hopefully, somebody else will pick up from here.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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