Hi Andrew,
That sounds like really good news. Thanks for updating us.
About the questions you asked - The peripheral blood review finding means that no plasma cells found in your *blood*. I think there are not normally many plasma cells in the blood anyway, but I just wanted to make clear that this finding is focused on plasma cells in the blood, not the marrow.
As for your bone marrow plasma cell percentage, I believe most doctors say that someone who is healthy (i.e., does not have multiple myeloma) will have a bone marrow plasma cell percentage of less than 5 percent. It isn't normal to have 0 percent plasma cells in the bone marrow because your body actually needs plasma cells to produce immunoglobulins to help defend against infection.
Or, to put it another way, plasma cells aren't all bad. What's bad is to have clonal, mutated plasma cells, which is what people with multiple myeloma have. Untreated, these reproduce uncontrollably, causing the high bone marrow plasma cell percentages you see in many patients at diagnosis.
I'm not sure I explained all of this very well, but I hope it helped at least some.
In any case, I'm glad you got the good news.
Forums
Re: Secondary MGUS M-spike levels
Hi Andrew,
It is important for clinicians and patients to not confuse 'secondary MGUS' with relapse, progression, or for that matter a new cancer.
Appearance of a new monoclonal band different form the original band identified at the time of diagnosis is common after autologous (self) and allogeneic (from another related or unrelated donor) stem cell transplantation. It is less commonly seen in myeloma patients who have not undergone a stem cell transplantation.
The change could occur in the form of a new light chain (e.g., kappa instead of lambda in a patient with a history of lambda myeloma) and/or a change in the heavy chain (e.g., IgG instead or IgA in a patient with IgA myeloma). Sometimes the band migrates in a different manner than the original band that was detected at the time of diagnosis.
While some studies have shown that this phenomenon is associated with improved outcome of patients, others have not been able to validate this favorable link.
In order to answer your question regarding the levels that were noted, I contacted the Mayo statistician who had worked on the Mayo series of 128 patients with secondary MGUS. The statistician provided the data that 15 patients had an M-spike between 1,000 and 2,000 mg/dL (1 and 2 g/dL, or 10 and 20 g/L), and only 2 had more than 2,000 mg/dL. Therefore, a good proportion of secondary MGUS patients indeed had an M-spike that was higher than 1,000 mg/dL.
Hope this answers your question.
Prashant
It is important for clinicians and patients to not confuse 'secondary MGUS' with relapse, progression, or for that matter a new cancer.
Appearance of a new monoclonal band different form the original band identified at the time of diagnosis is common after autologous (self) and allogeneic (from another related or unrelated donor) stem cell transplantation. It is less commonly seen in myeloma patients who have not undergone a stem cell transplantation.
The change could occur in the form of a new light chain (e.g., kappa instead of lambda in a patient with a history of lambda myeloma) and/or a change in the heavy chain (e.g., IgG instead or IgA in a patient with IgA myeloma). Sometimes the band migrates in a different manner than the original band that was detected at the time of diagnosis.
While some studies have shown that this phenomenon is associated with improved outcome of patients, others have not been able to validate this favorable link.
In order to answer your question regarding the levels that were noted, I contacted the Mayo statistician who had worked on the Mayo series of 128 patients with secondary MGUS. The statistician provided the data that 15 patients had an M-spike between 1,000 and 2,000 mg/dL (1 and 2 g/dL, or 10 and 20 g/L), and only 2 had more than 2,000 mg/dL. Therefore, a good proportion of secondary MGUS patients indeed had an M-spike that was higher than 1,000 mg/dL.
Hope this answers your question.
Prashant
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Dr. Prashant Kapoor - Name: Prashant Kapoor, M.D.
Beacon Medical Advisor
Re: Secondary MGUS M-spike levels
Thank you doctor it does answer my specific question. Of course, as you point out, the rub is always to distinguish secondary MGUS from disease progression or another cancer. I am assuming that my relatively benign bone marrow biopsy suggests strongly that what I have is secondary MGUS. At least, that's what my treating physician believes.
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goldmine848 - Name: Andrew
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 60
13 posts
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