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Reconciling FISH Results with Bone Marrow Biopsy Results

A MyMyelomaTeam Member asked a question 💭
New York, NY

I'll be running this question past my hem-onc at my next visit but thought I'd run it by you fine folks first. My BMB showed that of all cells that exist in the marrow, 15-20% were plasma cells, where normally only about 3% should be plasma cells. This represents a 12-17 percentage point difference, showing that the myeloma cells are proliferating and represent the vast majority of plasma cells in the marrow.

My FISH report stated, "MYC rearrangement and deletion of 13q14 in 4% and 6% of… read more

November 20, 2024
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A MyMyelomaTeam Member

Kappa,
This was one of the hardest things for me to understand.
Paula🌹

November 22, 2024
MyMyelomaTeam

It sounds like you're trying to reconcile the percentage of plasma cells found in your bone marrow biopsy (BMB) with the genetic abnormalities identified in your FISH (fluorescence in situ hybridization) report. Here are some points to consider:

- Bone Marrow Biopsy (BMB): Your BMB showed that 15-20% of the cells in your Show Full Answer

It sounds like you're trying to reconcile the percentage of plasma cells found in your bone marrow biopsy (BMB) with the genetic abnormalities identified in your FISH (fluorescence in situ hybridization) report. Here are some points to consider:

- Bone Marrow Biopsy (BMB): Your BMB showed that 15-20% of the cells in your marrow are plasma cells, which is significantly higher than the normal 3%. This indicates a proliferation of myeloma cells.

- FISH Report: The FISH report identified MYC rearrangement and deletion of 13q14 in 4% and 6% of cells tested, respectively.

- Understanding the Discrepancy: The percentage of cells showing genetic mutations in the FISH report does not necessarily correlate directly with the percentage of plasma cells in the BMB. FISH tests a sample of cells for specific genetic abnormalities, and the percentages reflect the proportion of cells with those mutations within the tested sample, not the entire population of plasma cells.

- Possible Explanations:
- Sampling Variability: The cells tested in the FISH analysis might not be a perfect representation of the entire marrow population.
- Heterogeneity of Myeloma Cells: Not all myeloma cells may carry the same genetic mutations. Some plasma cells might have different genetic profiles.

Discussing these results with your hematologist-oncologist will provide more personalized insights and help clarify any confusion.

November 20, 2024

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