Hi All,
Can progression to active (symptomatic) multiple myeloma from smoldering myeloma be diagnosed purely on the basis of blood tests?
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shep - Name: Shep
- Who do you know with myeloma?: me
- When were you/they diagnosed?: May 2014
- Age at diagnosis: 63
Re: Diagnosing progression to active multiple myeloma
Shep,
The vast majority of the factors that would qualify one for having symptomatic multiple myeloma (meeting one or more CRAB criteria or any of the new IMWG criteria found here,
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014.
can mostly be determined through blood tests alone.
But there are two big exceptions to this: The first is the "B" in CRAB or the focal lesion criteria listed in the IMWG link above (which, together, means the presence of focal or lytic lesions, or severe osteoporosis associated with multiple myeloma). These require radiological imaging to detect their presence. Many doctors request routine imaging for their smoldering patients as part of the ongoing monitoring process. However, other docs may not request imaging for routine monitoring purposes unless the patient presents with bone pain and/or there has been a significant turn in one's blood markers. I happen to have two doctors that fall into these two different camps.
The second exception is the bone marrow biopsy test. When you are first diagnosed, they should also have done a bone marrow biopsy (which it looks like they did in your case). If you are smoldering, a doctor likely won't request another bone marrow biopsy unless there is a significant change in your markers. But that bone marrow biopsy test alone can also produce results that would technically qualify you for having symptomatic multiple myeloma (> 60% plasma cells). But if you are secretory (which you are, since you have an M-spike), you would likely get a fair amount of warning through your blood tests if your plasma cell percentage went from 10% to 60%.
The vast majority of the factors that would qualify one for having symptomatic multiple myeloma (meeting one or more CRAB criteria or any of the new IMWG criteria found here,
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014.
can mostly be determined through blood tests alone.
But there are two big exceptions to this: The first is the "B" in CRAB or the focal lesion criteria listed in the IMWG link above (which, together, means the presence of focal or lytic lesions, or severe osteoporosis associated with multiple myeloma). These require radiological imaging to detect their presence. Many doctors request routine imaging for their smoldering patients as part of the ongoing monitoring process. However, other docs may not request imaging for routine monitoring purposes unless the patient presents with bone pain and/or there has been a significant turn in one's blood markers. I happen to have two doctors that fall into these two different camps.
The second exception is the bone marrow biopsy test. When you are first diagnosed, they should also have done a bone marrow biopsy (which it looks like they did in your case). If you are smoldering, a doctor likely won't request another bone marrow biopsy unless there is a significant change in your markers. But that bone marrow biopsy test alone can also produce results that would technically qualify you for having symptomatic multiple myeloma (> 60% plasma cells). But if you are secretory (which you are, since you have an M-spike), you would likely get a fair amount of warning through your blood tests if your plasma cell percentage went from 10% to 60%.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
2 posts
• Page 1 of 1