How "bad" Is This? It's So Confusing.
Bone marrow biopsy
Plasma cell neoplasm (~10-12% lambda restricted plasma cells in a ~20% cellular marrow) with high risk disease prognostic indicators.
(Lambda restricted plasma cell population (1% of total cells)
(Normal Karyotype)
Detected:
13q-/13:
1p32/1q21:
CCND1/IgH t(11;14):
Majority of his CBC & CMP has been normal. (Lymp has been low since teatment started). Albumin, Beta2, LDH is also normal
Lambda/Kappa ratio is off and has an M spike.
Lesion on occipital condyle (radiated)
I just… read more
Jo, he does have some high risk genetics, but that doesn't mean he will do poorly. I think his numbers look good after only 3 months of treatment. He does need the recommendations of a specialist however. He will need maintenance as well. Tell him not to be discouraged. It will get better 💕
Have your doctor explain this all to you. My husband is also "high risk". That means there are some chromozone deletions (the 13q and 1p32 and 1q21 refer to chromozones) which may make it more difficult to respond to standard treatments. However, don't be discouraged. There are lots of different treatments they can try. My husband has defied the "high risk" prognosis and has had only one treatment regimine and went into remission within four months and has stayed in remission for nearly 2 years. He started out with his first biopsy showing more than 60-70% plasma cells in the bone marrow. Your report says 10-12, and remission is considered less than 5%, so it sounds like yours was caught early. Treatments will lower the Lymph numbers, so that's not significant. If there is only one lesion, that's a good sign as well. If all the CBC and CMP numbers are normal, it doesn't sound like there has been any liver or kidney damage and the immune system is working, so that's good too. Beta2 and LDH are numbers they watch for the progression of the disease. If those are in normal range, that's a good sign too. I don't know much about the Lambda/Kappa ratio or the M spike--just that they watch those closely and use them for comparison on previous tests. Please go over all the numbers with your doctor--a good doctor is more than willing to explain in layman's terms what the numbers all mean. Treatment options are so many more now than 10 years ago, and if one doesn't work, they will try a different combination. Keep posting and tell us what your doctor says after you ask him about the bone marrow biopsy report.
Jo454, It sounds like to me that everything is improving, however, you still have a M Spike and your kappa/lambda ratio is not within normal limits, so hat indicates your Myeloma is still active. What did your doctor say? Only he can evaluate this clearly. Love, Marcia 🌸
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His Oncologist (not an MM specialist) said he could get him into remission. It's just a matter of how long he stays there. "Given his age and no other real health problems, he should do good." He also wants him to have the stem cell transplant. He's almost done with his 3rd month of VRD w/ Xgeva. His Kappa/Lambda ratio is better. We're looking into getting his neck stabilized now that the lesion has been radiated. He's been in that collar since July. (He still has to get a benign thyroid lesion removed also. Dr. won't do it until neck is stable.) He's just so fatigued and depressed because he can't function/work. I just want all the info I can get. I spend hours on the computer, but it gets confusing. Annecares, I'm so glad your husband has responded well. Prayers to both of you, and thank you for your help.
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