How would you approach a patient with solitary plasmacytoma with an FLC ratio >100, but a negative bone marrow biopsy and negative PET-CT?

Topics: Hematologic Malignancies • Medical Oncology • Myeloma • Hematology

Answer from: Medical Oncologist at Academic Institution

Are we to assume the Ca, Hgb, and creatinine are normal? Completing the testing with 24 hr UPEP with immunofixation is important. With a free light chain ratio of >100, there is generally proteinuria. If 24 hr urine total protein is 1 g/day or more, I would do a kidney biopsy to document light ch...

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Medical Oncologist at Locum Tenens
Would you recommend repeat bone marrow only if rad...

Medical Oncologist at OhioHealth
I would repeat BM bx now. If repeat BM bx shows 10...

Answer from: Medical Oncologist at Community Practice

Multiple myeloma is a patchy disease. It would explain the negative bone marrow biopsy.

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