Do cytogenetics from bone marrow aspirate change?
 

Hello,

I am new to this group. I have myeloma and am in a clinical treatment trial at the NIH. My question is can cytogenetic results change, or revert back to normal witout any treatment? My initial bone aspiration in 2009 showed translocations of the 17p/13 chromosomes (a p53 gene deletion). This is an unfavorable report and usually leads to a more aggressive disease course. Before i started my treatment this past July, i had another BMB/aspiration. It showed normal cytogenetics but the interpretation said the the aspirate was hypocellular and may have effected the results. The FISH analysis was not included on this report and i need to obtain it. The cytogenetics didn't effect my acceptance into the trial as i had other high risk findings. I am curious if the cytogenetics can change or if the report was most likely wrong due to poor sampling. I have another BMB coming up next month.

Thank you.

Bone marrow biopsies gather only small samples of cells, especially with hypocellularity. As a result, an abnormality may show up in one biopsy result but not the next. It's still there, just not in the sample.

For the same reason, an abnormality that's present in the bone marrow may be missed entirely because it didn't show up in any sample. If defects are increasing they may say that the disease is "evolving" but it can also be that different genetic abnormalities just happen to show up in different samples.

I wish the facts were otherwise and defective cells could repair themselves. But since spontaneous remissions are rare that's unlikely to be the explanation.