How often do you think a bone marrow biopsy is required?

@nohrt4me I was just reading more about that yesterday, how blood work is becoming sophisticated enough with NGS (next generation sequencing), that test results are on par with a bone marrow biopsy. While it won’t completely replace a bmbx it may reduce the need in certain circumstances, saving time, $$$ and anxiety for a lot of patients. ☺️

@nypara66 Same with me. I just have quarterly blood tests. My platelets stay between 450-500. I only take a baby aspirin as I am symptom free.

Hi @panamsandy ,
I do quarterly blood labs also and take low dose aspirin. I am fine with that and have no symptoms at all and never have had any, so I am not repeating all the other tests that have already been done on me. I do not have any high risk mutations and I know the bone marrow transplant specialist I saw one year ago told me that I do not fit into the categories they have. My not at all painful finger issue is an unusual case also that they have not figured out, even after five hand specialists’ different opinions.

It's going to depend on your situation. You'll hear about how very case is different, but unless you have active myeloma that really isn't a factor. They need an initial bone marrow if there's a possibility you might have SMM. That doesn't change management. It just helps them decide how closely you need to be monitored. The biopsy gives them quite a bit of information about what's going on in your marrow. They need to know how much of your clone they can see. Myeloma cells are patchy though so that number may not be as high as it could be from a random sample. Tests like flow cytometry and FISH give them more accurate counts of you normal cells, a place to test for amyloidosis early, and a look at some of your clone's genetics. Those numbers are more predictive than the percentage of clone so if any of the FISH tests fail you might need another biopsy. During watch and wait they are waiting for signs your disease is progressing but what they're watching for is change. If they think a biopsy will give them a better look at what might be changing you could be asked to do more biopsies even if you don't progress to active myeloma. To that extent "every case is different" matters does come into play. There isn't a set number of biopsies everyone is asked to undergo. It really depends on what your doctor thinks a biopsy will reveal and if the biopsy is the best way to get the information. Bone marrow biopsies are generally considered low risk for the majority of patients.