I am sorry to ask so many questions, but the more I learn the more questions I have. I had a flow cytometry test done last month because they were looking at leukemia. Would that test also test for all other problems with my blood?
The interpretations says no immunophenotypic evidence of non-Hodgkin lymphoma, acute leukemia or an increased number of blasts.
Lymphocytes 52.8%
Monocytes. 7.1%
Granulocytes. 34.8
Cd45 dim. 1.2
Cd45 neg .2
Plasma cells 0
Abnormal cells. None detected
This was blood. Would a flow cytometry for myeloma be done with the bone marrow?
Debi
Forums
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Debic - Name: Debi
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: August 2015
- Age at diagnosis: 57
Re: Have I progressed from MGUS to multiple myeloma?
Flow cytometry for multiple myeloma is done on the bone marrow aspirate today. Commercially available flow testing on peripheral blood for multiple myeloma patients isn't quite there yet, but we are waiting for that day.
For a patient that is suspected to have multiple myeloma, the flow cytometry machine is set up with probes that are looking for a handful of specific clusters of differentiation ("CDs") on the surface of the cells that are associated with multiple myeloma. The groupings of CDs (there are over 200 different CDs) on a cell's surface make up the immunophenotype of that cell. This immunophenotypic information is useful when diagnosing and monitoring multiple myeloma.
I'm also going to guess that a flow-cytometry machine that is configured to look at a patient with leukemia or lymphoma would be looking for some different CDs than those associated with multiple myeloma. But I'm only guessing on that point since I know next-to-nothing about leukemia and lymphoma.
For a patient that is suspected to have multiple myeloma, the flow cytometry machine is set up with probes that are looking for a handful of specific clusters of differentiation ("CDs") on the surface of the cells that are associated with multiple myeloma. The groupings of CDs (there are over 200 different CDs) on a cell's surface make up the immunophenotype of that cell. This immunophenotypic information is useful when diagnosing and monitoring multiple myeloma.
I'm also going to guess that a flow-cytometry machine that is configured to look at a patient with leukemia or lymphoma would be looking for some different CDs than those associated with multiple myeloma. But I'm only guessing on that point since I know next-to-nothing about leukemia and lymphoma.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Have I progressed from MGUS to multiple myeloma?
Thank you all for all of your answers and support. The bone marrow report is back and I know and I am happy, but have questions.
The doctor said she will check my blood in six months. What should I think? She said she couldn't explain why my ratios where out. She is still concerned that my Lymoh% is high 43.2. Should I go with waiting six months to recheck everything? With the history of breast cancer, I don't like the wait and see.
Debi
- Adequate bone marrow iron stores
- No increased reticulum fibrosis
- No morphological evidence of acute leukemia, increased blasts, lymhpoproliferative disorder, plasma cell neoplasm, myeloproliferative neoplasm, or myelodysplasia
The doctor said she will check my blood in six months. What should I think? She said she couldn't explain why my ratios where out. She is still concerned that my Lymoh% is high 43.2. Should I go with waiting six months to recheck everything? With the history of breast cancer, I don't like the wait and see.
Debi
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Debic - Name: Debi
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: August 2015
- Age at diagnosis: 57
Re: Have I progressed from MGUS to multiple myeloma?
I was diagnosed in June of 2012 with MGUS
Free kappa lt chain 9.69
Free lambda lit chain 10.87
Ratio 0.89
It stayed this was until July 2015
Free kappa lit chain 9.96
Free lambda lit chain 3.45
Ratio 2.89
February 2016
Free kappa lit chain 8.17
Free lambda lit chain 1.58
Ratio 5.17
My b2m has stayed at 1.54
This seems like a big change in a short time. My doctor wants to retest in six months.
What would you do? If I need a second option, where should I go? I live in Tampa. I have family in Houston.
Thanks for your thoughts.
Debi
Free kappa lt chain 9.69
Free lambda lit chain 10.87
Ratio 0.89
It stayed this was until July 2015
Free kappa lit chain 9.96
Free lambda lit chain 3.45
Ratio 2.89
February 2016
Free kappa lit chain 8.17
Free lambda lit chain 1.58
Ratio 5.17
My b2m has stayed at 1.54
This seems like a big change in a short time. My doctor wants to retest in six months.
What would you do? If I need a second option, where should I go? I live in Tampa. I have family in Houston.
Thanks for your thoughts.
Debi
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Debic - Name: Debi
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: August 2015
- Age at diagnosis: 57
Re: Have I progressed from MGUS to multiple myeloma?
Hi Debi,
I must admit, this is a bit baffling to me.
You have normal bone marrow biopsy results, no M-spike, but varying FLC results (although your FLCs are not off dramatically). But note that bone marrow biopsies can be hit-or-miss affairs since myeloma is not evenly spread throughout one's bone marrow.
But assuming that your bone marrow biopsy results are accurate for the moment, I'm wondering if you might have some sort of renal impairment issue going on that might be throwing off your FLC numbers?
What have your creatinine, BUN and eGFR been doing during this time (these all can be used to track kidney health)?
Have you ever had a 24-hour urine test performed (as opposed to a random urine sample test collected at the doctor's office)? If so, were all the results of that test normal?
Did your bone marrow biopsy test include a Congo red stain test (just look for the word "Congo" in the test report?
In any case, I always think that getting a second opinion is a good idea. In Houston, you have MD Anderson. In Tampa, you have the Moffitt Cancer Center. Others on the forum might have additional suggestions.
I must admit, this is a bit baffling to me.
You have normal bone marrow biopsy results, no M-spike, but varying FLC results (although your FLCs are not off dramatically). But note that bone marrow biopsies can be hit-or-miss affairs since myeloma is not evenly spread throughout one's bone marrow.
But assuming that your bone marrow biopsy results are accurate for the moment, I'm wondering if you might have some sort of renal impairment issue going on that might be throwing off your FLC numbers?
What have your creatinine, BUN and eGFR been doing during this time (these all can be used to track kidney health)?
Have you ever had a 24-hour urine test performed (as opposed to a random urine sample test collected at the doctor's office)? If so, were all the results of that test normal?
Did your bone marrow biopsy test include a Congo red stain test (just look for the word "Congo" in the test report?
In any case, I always think that getting a second opinion is a good idea. In Houston, you have MD Anderson. In Tampa, you have the Moffitt Cancer Center. Others on the forum might have additional suggestions.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Have I progressed from MGUS to multiple myeloma?
Multibilly,
Thanks for your reply.
Creat feb 2015 .8
Jun 2015 .8
Feb 2016 .6
Bun. Feb 2015 12
Jun 2015 11
Feb 2016 15
EGFr Feb 2015 79
Jun 2015 79
Feb 2016 109
The bone marrow report states:
No evidence of involvement by lymhpoproliferative neoplasm or plasma cell dyscrasia.
The only thing on the report that has any referral to staining is reticulum shows no increase in reticulin fibrosis iron stains reveal positive hemosiderin deposits within the reticle endothelial cells. No increased ring sideroblasts are identified. pAS stain x2 showed compatible and similar findings to routine stain.
I must admit I have no idea what any of this means.
I did have a 24-hour urine test in February 2015; I do not have a copy of that report.
One thing I notice is my sugar is high on every blood test.
Thank you for taking the time to look at this.
Debi
Thanks for your reply.
Creat feb 2015 .8
Jun 2015 .8
Feb 2016 .6
Bun. Feb 2015 12
Jun 2015 11
Feb 2016 15
EGFr Feb 2015 79
Jun 2015 79
Feb 2016 109
The bone marrow report states:
No evidence of involvement by lymhpoproliferative neoplasm or plasma cell dyscrasia.
The only thing on the report that has any referral to staining is reticulum shows no increase in reticulin fibrosis iron stains reveal positive hemosiderin deposits within the reticle endothelial cells. No increased ring sideroblasts are identified. pAS stain x2 showed compatible and similar findings to routine stain.
I must admit I have no idea what any of this means.
I did have a 24-hour urine test in February 2015; I do not have a copy of that report.
One thing I notice is my sugar is high on every blood test.
Thank you for taking the time to look at this.
Debi
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Debic - Name: Debi
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: August 2015
- Age at diagnosis: 57
Re: Have I progressed from MGUS to multiple myeloma?
Debi,
What does your lab say is normal for all these various lab results (especially your eGFR)?
You might want to ask for a copy of your 24 hour urine test.
BTW, you would be amazed how much you can influence your glucose levels through diet. If I cut down carbs and sugars a few days before a lab test, I can pretty easily drop my glucose number about 30 mg/dL.
What does your lab say is normal for all these various lab results (especially your eGFR)?
You might want to ask for a copy of your 24 hour urine test.
BTW, you would be amazed how much you can influence your glucose levels through diet. If I cut down carbs and sugars a few days before a lab test, I can pretty easily drop my glucose number about 30 mg/dL.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Have I progressed from MGUS to multiple myeloma?
This is what the lab test says are the ranges.
EGRF 60 to 200
Creat 0.3 to 1.2
Kappa 3 to 20
Lambda 5 to 26
I will get a copy of the 24-hour urine test.
EGRF 60 to 200
Creat 0.3 to 1.2
Kappa 3 to 20
Lambda 5 to 26
I will get a copy of the 24-hour urine test.
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Debic - Name: Debi
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: August 2015
- Age at diagnosis: 57
Re: Have I progressed from MGUS to multiple myeloma?
I don't know what to say since all your kidney markers look normal too. But, I'm not a doc. A second opinion still sounds like a great idea.
I would also ask your doc if he/she still thinks your diagnosis of a plasma cell disorder (whether it be MGUS or otherwise) is still valid.
I would also ask your doc if he/she still thinks your diagnosis of a plasma cell disorder (whether it be MGUS or otherwise) is still valid.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Have I progressed from MGUS to multiple myeloma?
Meaning it could be more advanced or that it could be something other than MGUS ?
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Debic - Name: Debi
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: August 2015
- Age at diagnosis: 57
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