Bone marrow biopsy and/or blood tests for MGUS

@lpro After conferring with my physicians I have opted not to have a BMB at this time. My numbers are very stable. No invasive medical procedure is without risk. If my numbers reached a threshold of concern, by all means I would agree to have one.
https://www.myeloma.org/videos/do-patients-mgus-always-need-undergo-bone-marrow-test

I am lost now. I thought the diagnosis of MGUS included a bone marrow with < 10% plasma cells. Can that be confirmed any other way?

@lpro After conferring with my physicians I have opted not to have a BMB at this time. My numbers are very stable. No invasive medical procedure is without risk. If my numbers reached a threshold of concern, by all means I would agree to have one.
https://www.myeloma.org/videos/do-patients-mgus-always-need-undergo-bone-marrow-test

The study you reference is not yet complete, but the abstract of a 2024 interim report is at https://www.acpjournals.org/doi/10.7326/M23-2540

In many cases, it's not clear to me why a study of how blood tests may predict BMB results matters. For anyone in the gray treatment/nontreatment zone - me, for example - BMB results matter a great deal. Of course, any medical procedure has risks, but a BMB is quite safe. I for one would not accept a prediction in place of the actual result.

Hello all,
I was diagnosed with MGUS in June 2023 and I've got some questions for anyone willing to answer. I've been reading posts on here about people with MGUS having bone marrow biopsies done. Others that see their Hematologist every 3 months, some who see theirs every 6 months. Can I ask those that have had the biopsies done, what precipitated you into having the biopsy in the first place? Was it a progression of your MGUS? Was it at your request or your doctor's? When I was diagnosed, the doctor I had, who I did not like, told me I had nothing to worry about that my MGUS probably wasn't going to progress into anything further. This same doctor also told me that I would test negative for a Free Light Chain Test but he was going to run it anyway. I told him not to speak too quickly because I would show him otherwise. Which I did. I tested positive, but that didn't seem to faze him or change his diagnosis or outlook on me and my situation. It is time for me to go back for a follow up appointment and I've been granted a different doctor (undetermined at this time) to see. Can I also get opinions as to whether or not you guys think I should ask for a completely new work up by this new doctor so it is an unbiased diagnosis? Or?? I don't know what to do or ask for or expect....I need some good solid advice and help, no one around me has the answers as this isn't something they've dealt with. Thank you in advance for your help, knowledge and understanding with my many questions....I do sincerely appreciate any and all help and advice.

Hello all,
I was diagnosed with MGUS in June 2023 and I've got some questions for anyone willing to answer. I've been reading posts on here about people with MGUS having bone marrow biopsies done. Others that see their Hematologist every 3 months, some who see theirs every 6 months. Can I ask those that have had the biopsies done, what precipitated you into having the biopsy in the first place? Was it a progression of your MGUS? Was it at your request or your doctor's? When I was diagnosed, the doctor I had, who I did not like, told me I had nothing to worry about that my MGUS probably wasn't going to progress into anything further. This same doctor also told me that I would test negative for a Free Light Chain Test but he was going to run it anyway. I told him not to speak too quickly because I would show him otherwise. Which I did. I tested positive, but that didn't seem to faze him or change his diagnosis or outlook on me and my situation. It is time for me to go back for a follow up appointment and I've been granted a different doctor (undetermined at this time) to see. Can I also get opinions as to whether or not you guys think I should ask for a completely new work up by this new doctor so it is an unbiased diagnosis? Or?? I don't know what to do or ask for or expect....I need some good solid advice and help, no one around me has the answers as this isn't something they've dealt with. Thank you in advance for your help, knowledge and understanding with my many questions....I do sincerely appreciate any and all help and advice.

@newfiesgirl1 The relationship of trust must be present in the doctor and patient relationship. I would make sure the doctor is expert in the MGUS/Myeloma diagnosis and causation. I go to the major Cancer hospital(an hour drive) in my area and have the Multiple Myeloma team overseeing my care. I do not try and 2nd guess them. I am a nurse and evaluated their credentials before I went. So first, find your major cancer center. Get a referral for appointment with the MGUS/Myeloma team. The big ones may even have a MGUS clinic. You may not even need a referral. Be clear to tell them u are diagnosed with MGUS at this time. IF it is a major center it will have at least a blood cancer section if not a MGUS/Myeloma section and chief. I feel very comfortable with them as I email them within new symptoms and concerns and they send me responses and anything they want me to do before next appointment. Many community cancer centers treat this disease as a "nothing to see here" thing. A true cancer center treats it like a precancerous conditions and monitors according to risk. I also keep my primary informed and she orders the usual blood tests for MGUS. So she is on top of disease as well. For example, I had some protein in my urine. My MGUS team when I mentioned this wants me to bring a 24 hour urine with me at next appointment. No urgency with this but an addition and followthrough. That tells me now not to worry to much as if it were urgent they would move my appointment, rest etc up. So I keep both sides informed. The other issue with MGUS is the blood work. The M spike does not always appear. However other things do appear ie as previously mentioned protein in urine. You have to first find the right physician attached to as big a center as you are reasonably close to and work with primary to keep informed and collaborative. My primary knows, regardless of her beliefs, I consider this very important especially at my age. 83! I don't want to progress any sooner than I should and maybe not at all. It is good, at least with my primary, to keep her informed. She doesn't want to miss a diagnosis and have them find it at the cancer center next appointment. Keeps them on their toes. Question- why are you letting someone else choose your cancer doctor? You should choose him or her. Just a thought. Look up credentials, patient commentary and also watch any videos they have posted. If you need a referral, find the doctor you want and have primary make a referral specifically to that doctor. Just thoughts due to my career spent as a nurse. You need to be your own best advocate as our medical system leaves something to be desired.

Thanks for the link. It appears that the study is using patients: 1043 persons with IgG, IgA, light-chain, and biclonal MGUS detected by screening and an interpretable bone marrow sample.
I have IgM MGUS with levels going up very quickly. I wanted to get a prognosis based on this calculator. https://awmrisk.com/index.html
I already have all the values except the % needed from a BMB. If I had a good way of estimating the BMB results, I would put off having the actual BMB until it was estimated to be over 10%.
I'm now guessing that since the study doesn't include any IgM people, the authors knew it wouldn't be applicable because maybe IgM people are looking at WM rather than MM.