[jebil]

What stage is my mother's multiple myeloma?

by jebil on Sat Apr 16, 2016 1:27 pm

Hi,

My mother got diagnosed with multiple myeloma. Doctor didn't tell me of her stage, prognosis etc. He told me to wait for the final IHC results, even though it is confirmed.

Please find below the test results.

Serum electrophoresis:

Thick M band at gamma globulin position (50.5%)
Albumin / globulin ratio 0.55
Gamma globulin 7.16 g/dL

X-ray skull shows minor lytic lesion in two positions.

ESR: 132mm/hr
Hemoglobin: 9.4L gm/dL
S.calcium: 9 mg/dl
No renal failure

Bone marrow results
I PBF no significant anomaly
II & III BMA, BMI & BMB trilineage hemopoiesis and large islands of plasma (54%)

Beta 2 microglobulin : 2634

kappa - 12 (normal)
lambda - 5.32 (less)
kappa/lambda - 2.256 (higher)

IgG - 7754 mg/dL
IgM - <20 mg/dL
IgA - <10 mg/dL

She is having severe pain on her back. No other physical identifications.

Please help me in understanding her stage and what to expect in the future.

Thanks,

[cdnirene]

Re: What stage is my mother's multiple myeloma?

by cdnirene on Mon Apr 18, 2016 1:19 pm

Hi Jebil,

Unlike in solid tumor cancers, stage does not really predict the future. I didn't even know there were stages for myeloma when I was diagnosed. I found out and asked my doctor 4 months later. I was Stage 3. I just mentally shrugged. At that point, I had been in remission for a month and my kidneys had recovered from renal failure. It's now 19 months since my myeloma diagnosis and I am still in remission. I recently read a post by someone who said she was diagnosed as Stage 3 in 2005.

The big question is how will your mother responds to treatment. I was fortunate that I responded extremely well to the first treatment tried.

So the tests your doctor ordered will help decide the course of treatment but really won't provide a prognosis. Even your doctor doesn't know for sure how well a specific treatment will work.

[Multibilly]

Re: What stage is my mother's multiple myeloma?

by Multibilly on Mon Apr 18, 2016 6:24 pm

Hi Jebil,

Irene is right. Stage in multiple myeloma doesn't really matter all that much regarding what the future holds.

However, you are going to want to know and follow her "M-spike" to see how she responds to treatment. You should find something called abnormal protein band, M-spike, paraprotein, M-protein, or something like that on her serum electrophoresis test.

She also has what is called "immunoparesis" since her IgM and IgA are both low. You want to see these come back up into the normal range after she begins treatment.

I'm just a little surprised that she has back pain but only lytic lesions on her skull. She might be well served to get an MRI of her spine or a PET/CT of her body to see if there is any spinal damage that the xray missed.

What is also important to understand are the results of her cytogenetic and FISH results from her bone marrow biopsy test. There are sometimes some very specific genetic mutations that are discovered in these tests that are important to understand when it comes to the correct selection of treatment drugs and her prognosis.

Most importantly is that she be seen by a top multiple myeloma specialist (not just a hematologist/oncologist that may have some multiple myeloma patients). If you let us know what city she is in, folks on the forum can make some recommendations on where to find these specialists in her area.

Hope this helps a bit.

[jebil]

Re: What stage is my mother's multiple myeloma?

by jebil on Tue Apr 19, 2016 2:40 pm

Hi Irene, Multibilly

Thanks for your replies.

Just got her spinal MRI scan results. She has multiple fractures in it, that's what causing severe pain. Doctor said any surgery or radiation won't do much help, it'll become okay once treatment gets at some point (is it so?). And the pain got severe in just one day, probably because the weak ones broke. Oncologist says from the biopsy and M-protein test, it appears to be stage 3, but she has no kidney issues, no higher calcium contents (she was taking calcium tablets too, because it was low). Is this expected for myeloma? Could it be anything other than myeloma?

We are from Kerala, India. I don't think any Indian cities have the facility for FISH.

Thank you so very much,
Jebil

[Robin]

Re: What stage is my mother's multiple myeloma?

by Robin on Sat Apr 23, 2016 11:10 am

Hi Jebil

I am a multiple myeloma patient from Mumbai, India. Diagnosed Nov 2013, 4 cycles VCD, 4 cycles RVD and since Nov 2014, on single agent Velcade maintenance.

FISH tests are available in India. I know because I did mine in Mumbai when I was diagnosed. There may be centres in Kerala doing likewise I think.

Good luck to your Mum.

Regards,

Robin

[jebil]

Re: What stage is my mother's multiple myeloma?

by jebil on Tue Apr 26, 2016 1:59 am

Hi Robin,

Thanks for the reply, wish you a long healthy life.

What still confuses me is the blood calcium level. It is low now, and taking calcium tablets.

I have read many places that myeloma causes high calcium levels in the blood.