Bone Marrow Biopsy - Low Level Plasma Cell Neoplasm

[curious]

Hello it is very difficult to find information on understanding bone marrow results related to MGUS and/or multiple myeloma stages including indicators on precursers and what they may mean.
I am curious to understand how the markers are important and how often there are abnormal results in the marrow not yet showing in the blood - How do you know which questions you should be asking next?

Fish for Plasma cell Prolifer Disorder:
Insufficient plasma cells were observed. This result does not exclude proliferative disorder.

200 cell counts - lymphocyte, neurtophil, metamyelocyte, promyelocyte, blast, monocyte, esoinophil basophil - all within normal range

500 cell counts -blast 4.0H, Promyleocytes 0.6L, other granulocyte precursors 49.8H, Erthroid precursors 27.8H - other counts within range
1. How can a 200 cell count vs a 500 cell count give different counts or indications of High/Low results.

Cellularity: slightly hypocellular 40percent
Erthoroid Elements: full spectrum maturation with mild stress dyserythropoiesis
2. what is dyserythropoiesis in the bone marrow? How does it show in the bone marrow and not the blood?

Myeloid Elements - marginal increase
3. Does Myeloid elements show up in MGUS, Myeloma or only the leukemia subsets

Megakaryoctytes: Increased with unremarkable morphology
there is no significant rouleaux formation
occassional reactive lymphocytes

Antigens analyzed:
cd19, cd20, cd45, cd56 and lambda negative
cd38 and ckappa bright
CD138 moderate which plasma cells comprise 6-8% of marrow cellularity
CD117 Kit - Positive dim
plasma cells predominantely kappa light chain

How does a CD117+ influence decisions on the next step? Or doesn't it?

[Birgitta-A]

Hi curious,
Most members of this forum have Myelodysplastic syndromes or Aplastic anemia - I am afraid we can't answer questions about Myeloma or MGUS. There are many support groups for Myeloma patients like this one: http://myeloma.org/Main.action
Kind regards
Birgitta-A

[curious]

I appreciate the response - i'm being "watched" for mds syndrome per my biopsy result they can't yet explain some of the things happening. My Hemotalogist seems focused only on MGUS/MM and did not go any further with the testing. I was hoping that based on bone marrow that others would have opinions on further evaluation for the RA or the MDS - testing that should be done. I apologize if i posted in the wrong forum.
thank you

[Birgitta-A]

Hi curious,
You know if you suspect RA we would like to know you hemoglobin - if you don't have low hemoglobin (anemia) I don't think you can have RA.

Cellularity: slightly hypocellular 40percent. That can be normal - the cellularity decreases with age and we don't know your age.

Erthoroid Elements. Erythroid elements means red blood cells from very young to mature cells.

Mild stress dyserythropoesis means that the manufacturing of the red blood cells is a little disturbed due to that the bone marrow has to work a little harder than normal in order to increase the red blood cells

What is dyserythropoiesis in the bone marrow? Some of the red blood cells are misshaped - very few in your case.

How does it show in the bone marrow and not the blood? As far as I understand the misshaped blood cells never leave the bone marrow or are caught by the spleen very soon so we don't find them in blood.
Kind regards
Birgitta-A

[curious]

Cellularity: slightly hypocellular 40percent. That can be normal - the cellularity decreases with age and we don't know your age.

I am 48 my understanding is it should be around 52%

thank you for some clarifications, i'm not sure what my hemoglobin was at.