study of multiple myeloma occurrence in patients with 5%10% bone marrow plasma cells: a case series regarding revised imwg diagnostic criteria

Introduction: utilizing lower limit of bone marrow plasma cells (bmpcs) is the main existing criterion to diagnose multiple myeloma (mm). according to the revised international myeloma working group (imwg) diagnostic criteria, the value of 10% is agreed among experts as the cut off level for diagnosis. symptomatic patients with bmpc above this value are identified as definite cases of mm. however, there are mm patients who have bmpc of less than 10%. therefore, the above-mentioned cut off point could delay the diagnosis, which in turn results in adverse effects in patients’ clinical course. case presentation: the current study represented data from consecutive patients with 5%- 10% bmpc at our center from 2004 to 2013. mm existed among patients, as expected. this series provides a quantitative approximation of mm prevalence in the studied cases. conclusion: the reported patients’ status demonstrated the limitations of the abovementioned cutoff criterion to diagnose myeloma, and emphasizes the importance of employing further diagnostic procedures in patients with marginal amounts of bmpc and high clinical suspicion. it is shown that supplementary examination is especially required for two subgroups of patients with certain clinical and laboratory characteristics.