What percentage of bone marrow plasma cells are present in multiple myeloma?
Nov 03, 2025
Source: Cainiu Health
Dr. Chen Jian
Introduction
In the diagnosis of multiple myeloma, the proportion of plasma cells in the bone marrow is one of the key criteria. In most patients, bone marrow aspiration reveals a plasma cell percentage exceeding 10%. These abnormal plasma cells suppress normal hematopoietic function, leading to anemia, thrombocytopenia, and other issues. They also secrete abnormal immunoglobulins, causing complications such as renal dysfunction and bone pain.
Under normal circumstances, patients with multiple myeloma typically have a bone marrow plasma cell percentage ≥10%, along with characteristic features such as monoclonal immunoglobulin abnormalities or lytic bone lesions. A significantly elevated plasma cell proportion may indicate more active disease. If there are concerns, early medical consultation is recommended. Detailed analysis is as follows:
In diagnosing multiple myeloma, the proportion of plasma cells in the bone marrow is one of the key criteria. In most patients, bone marrow aspiration reveals plasma cells accounting for more than 10% of nucleated cells, and in some cases this can exceed 30%. These abnormal plasma cells suppress normal hematopoiesis, leading to anemia and thrombocytopenia. They also secrete abnormal immunoglobulins, which can cause complications such as renal dysfunction and bone pain. A higher plasma cell percentage generally indicates a greater tumor burden.
In rare cases, some patients may be diagnosed with multiple myeloma even if their bone marrow plasma cell percentage is below 10%, provided they have clear lytic bone lesions, markedly elevated monoclonal immunoglobulin, and other differential diagnoses have been ruled out. Additionally, when the plasma cell proportion ranges between 5% and 10%, clinicians should consider the possibility of smoldering multiple myeloma by integrating clinical symptoms and other test results. This condition progresses slowly but still requires long-term follow-up and monitoring.
When multiple myeloma is suspected, timely bone marrow aspiration should be performed to ensure accurate diagnosis. After confirmation, a comprehensive evaluation should be completed according to medical guidance to develop an individualized treatment plan. During treatment, regular monitoring of bone marrow plasma cell percentage is essential to track disease progression, and patients should avoid adjusting their treatment regimens independently, which could compromise therapeutic outcomes.
