1. < Blood Cancers & Disorders

Mildly Hypocellular bone marrow (40% cellularity) with MGUS

Posted by hpatel334 @hpatel334, Aug 17, 2023

Hello all. I am 24 years old, male. I was diagnosed with MGUS in December 2021. Since then, My M protein has gone from 0.3 to 0.6, which caused my hematologist to do a bone marrow biopsy. The results confirmed MGUS with 3.4% plasma cell involvement and confirmed MGUS. I am IGG Lambda with normal kappa/lambda ratio. PET CT also no evidence of neoplasm.

However, there was a finding on there that had me slightly worried. It said my marrow was mildly hypocellular for my age, and this is what it said:
"The myeloid to erythroid ratio is decreased. ERYTHROID ELEMENTS: Maturation is complete with no dysplasia. MYELOID ELEMENTS: Maturation is complete with no dysplasia. Blasts are not
increased."

My hematologist has not said anything about this, but this has been anxiety filled as this seemed abnormal. I have normal CBC numbers. However, I have always had WBC and Platelets at the lower end of the ranges. Sometimes abnormal but sometimes just over the line. I do not have a weakened immune system. I do feel tired sometimes, but I work a pretty demanding physical job. Should I be worried about anything at this stage? My biopsy didn't show anything else that was abnormal. I have also been checked for rheumatological issues, but everything came out negative a year ago when they suspected something. I take Vitamin D and B12 regularly.

Interested in more discussions like this? Go to the Blood Cancers & Disorders Support Group.

barbdk | @barbdk | Aug 18, 2023

That’s a great question for your physician. Just drop a question into your patient portal. There’s no need to worry when I’m guessing the fact that he didn’t raise it as a concern is because it’s not something to worry about. When you get an answer, tell us, we can all learn something!

REPLY
1 reply
hpatel334 | @hpatel334 | Aug 18, 2023
In reply to @barbdk "That’s a great question for your physician. Just drop a question into your patient portal. There’s..." + (show)
@barbdk

That’s a great question for your physician. Just drop a question into your patient portal. There’s no need to worry when I’m guessing the fact that he didn’t raise it as a concern is because it’s not something to worry about. When you get an answer, tell us, we can all learn something!

Jump to this post

Will do! I have my visit on 9/14 so will try to keep my anxiety low till then :). Thank you for responding

REPLY
1 reply
barbdk | @barbdk | Aug 18, 2023
In reply to @hpatel334 "Will do! I have my visit on 9/14 so will try to keep my anxiety low..." + (show)
@hpatel334

Will do! I have my visit on 9/14 so will try to keep my anxiety low till then :). Thank you for responding

Jump to this post

Never be hesitant to ask a question. Most of mine come on the drive home 😏

REPLY
Mentor
Lori, Volunteer Mentor | @loribmt | Aug 18, 2023

Good morning and welcome to Connect @hpatel334. You’ve been diagnosed with Monoclonal gammopathy of undetermined significance (MGUS). It indicates there’s an abnormal protein found in your blood. It can eventually cause tissue damage if the level becomes too high. It’s a condition that bears watching over time but for many people it’s one of those active surveillance conditions which don’t progress.

From my understanding, right now there’s nothing that requires treatment for you but you’re concerned about findings with the bone marrow biopsy and exam (bmbx) with the comment stating that your marrow is mildly hypocellular for your age. The bone marrow is the heart of the blood manufacturing site in the body, responsible for red & white blood cells and platelets. The bmbx allows for an in-depth look at the marrow directly from the source, providing a detailed picture of the marrow’s ability to produce healthy blood products. Your tests revealed that you have 40% cellularity, which is low but still in the normal range for your age. (Age 20-70 years range 40%-70%). Findings suggests your bone marrow is healthy but not producing blood products at a robust capacity.
All your other tests came clean and scans show there are no tumors. From the biopsy where it states Erythroid/Myeloid elements are complete with no dysplasia, that would indicate the White and Red blood cells you have are mature and not showing signs of any deformities. Which is great!
Especially important is that the tests show no abnormal increase of blasts. Blasts are immature white blood cells and if there is an over abundance of those that can be an indication of leukemia.

At 24, these should be some of the more carefree times of your life and instead you’re having to worry about bone marrow biopsies and blood work. From experience I know how this can overtake our thoughts but it’s so important to not let this be pervasive. What you have may not progress over time so right now it’s important to just go on living your normal life. Have your regular blood work just to keep tabs on any changes and if things do change then you’ll deal with.
How often does your hematologist want to check your blood work?

REPLY
1 reply
hpatel334 | @hpatel334 | Aug 18, 2023
In reply to @loribmt "Good morning and welcome to Connect @hpatel334. You’ve been diagnosed with Monoclonal gammopathy of undetermined significance..." + (show)
@loribmt

Good morning and welcome to Connect @hpatel334. You’ve been diagnosed with Monoclonal gammopathy of undetermined significance (MGUS). It indicates there’s an abnormal protein found in your blood. It can eventually cause tissue damage if the level becomes too high. It’s a condition that bears watching over time but for many people it’s one of those active surveillance conditions which don’t progress.

From my understanding, right now there’s nothing that requires treatment for you but you’re concerned about findings with the bone marrow biopsy and exam (bmbx) with the comment stating that your marrow is mildly hypocellular for your age. The bone marrow is the heart of the blood manufacturing site in the body, responsible for red & white blood cells and platelets. The bmbx allows for an in-depth look at the marrow directly from the source, providing a detailed picture of the marrow’s ability to produce healthy blood products. Your tests revealed that you have 40% cellularity, which is low but still in the normal range for your age. (Age 20-70 years range 40%-70%). Findings suggests your bone marrow is healthy but not producing blood products at a robust capacity.
All your other tests came clean and scans show there are no tumors. From the biopsy where it states Erythroid/Myeloid elements are complete with no dysplasia, that would indicate the White and Red blood cells you have are mature and not showing signs of any deformities. Which is great!
Especially important is that the tests show no abnormal increase of blasts. Blasts are immature white blood cells and if there is an over abundance of those that can be an indication of leukemia.

At 24, these should be some of the more carefree times of your life and instead you’re having to worry about bone marrow biopsies and blood work. From experience I know how this can overtake our thoughts but it’s so important to not let this be pervasive. What you have may not progress over time so right now it’s important to just go on living your normal life. Have your regular blood work just to keep tabs on any changes and if things do change then you’ll deal with.
How often does your hematologist want to check your blood work?

Jump to this post

@loribmt Thank you for your message! I appreciate this. To answer your question, my hematologist wants to be more aggressive, and I am having to do 3-month tests for the next year. Once these show a stable trend, she will shift me to a 6 month or 1 year period. Because the M protein spike went from 0.3 to 0.6 within 1.5 years of my diagnosis, she recommended this. I wish I was on 6 month or 1 year period especially now that the bmbx results show no major signs or concerns.

REPLY
2 replies
Mentor
Lori, Volunteer Mentor | @loribmt | Aug 18, 2023
In reply to @hpatel334 "@loribmt Thank you for your message! I appreciate this. To answer your question, my hematologist wants..." + (show)
@hpatel334

@loribmt Thank you for your message! I appreciate this. To answer your question, my hematologist wants to be more aggressive, and I am having to do 3-month tests for the next year. Once these show a stable trend, she will shift me to a 6 month or 1 year period. Because the M protein spike went from 0.3 to 0.6 within 1.5 years of my diagnosis, she recommended this. I wish I was on 6 month or 1 year period especially now that the bmbx results show no major signs or concerns.

Jump to this post

@hpatel334. From the information you provided, the scans and the bmbx results appeared encouraging, so that will help your hematologist in decision making in the future. It’s also encouraging that you have a doctor who is going the extra mile in having you get bloodwork done every 3 months for that first year. It is important for establishing a baseline and then tracking those all important trends. I have graphs and flow charts for everything, so I can relate! 😅 Four years ago I had a very aggressive form of leukemia which required a bone marrow transplant…giving me a completely new immune system…happy marrow! I’m in a durable remission and feel as though nothing ever happened, super healthy and active. So I know my way around blood work and bone marrow biopsies. And also, that these things can be overcome. That’s why I do my best to instill a sense of calmness with a new diagnosis. It may change our life but doesn’t have to define us. ☺️
I see you have an appointment with your hematologist in a month so don’t stop back with questions or comments, ok?

REPLY
Mentor
Patty, Volunteer Mentor | @pmm | Aug 19, 2023
In reply to @hpatel334 "@loribmt Thank you for your message! I appreciate this. To answer your question, my hematologist wants..." + (show)
@hpatel334

@loribmt Thank you for your message! I appreciate this. To answer your question, my hematologist wants to be more aggressive, and I am having to do 3-month tests for the next year. Once these show a stable trend, she will shift me to a 6 month or 1 year period. Because the M protein spike went from 0.3 to 0.6 within 1.5 years of my diagnosis, she recommended this. I wish I was on 6 month or 1 year period especially now that the bmbx results show no major signs or concerns.

Jump to this post

Greetings! Welcome to the group. You have received a lot of good information and I have little to offer short of encouraging you to use your patient portal to ask any questions you may have that were not addressed by your physician.
At 24 you have oh so many fun things to occupy yourself with and I hate that you have worry hanging around.
Physicians are busy humans, but they will answer your questions. Don’t force yourself to sit with anxiety for nearly a month. Anxiety can be brutal.
Glad you found us!
Patty

REPLY
Please sign in or register to post a reply.