[Beckiwecki]

Anxious about lab results, possible multiple myeloma

by Beckiwecki on Tue Oct 20, 2015 11:55 am

Hi!

I'm very anxious as I know some of my lab work that came back. I have my bloodwork, which I will post below. And I'm even more anxious because I had a 24-hour urine and it should have posted online the results by now, but they just aren't there yet.

I'm being worked up for multiple myeloma for a few reasons. One my protein levels have been consistently on the high side since March 2014. This past April I broke my leg and ankle just getting out of bed. Bad enough that I have a plate with 6 screws in my leg.

I might also add that I am only 31 years old. I have aches and pains all over my body, mainly in my back and neck. I've also had some periods of time with confusion and disorientation. Followed by weakness and extreme fatigue.

Here is all the bloodwork that the oncologist has done:

Specimen Date/Time 9/30/2015 4:16:00 AM
Gender: Female
Report Date: 9/30/2015 12:00 AM

Result Value Units Range Lab
COMPLETE BLOOD COUNT
WBC 8.1 x10^3/UL 4.2-10.0 LabPak-NOR-EG
RBC 3.84 x10^6/UL 3.80-5.40 LabPak-NOR-EG
HGB 11.3 Low g/dL 12.0-16.0 LabPak-NOR-EG
HCT 32.7 Low % 37.0-47.0 LabPak-NOR-EG
MCH 29.3 PG 27.0-34.0 LabPak-NOR-EG
RDW 15.4 High % 11.5-15.0 LabPak-NOR-EG
PLAT 285 x10^3/UL 140-440 LabPak-NOR-EG
MPV 7.4 Low fL 7.5-11.5 LabPak-NOR-EG
LYMPH# 2.4 x10^3/UL 1.2-3.4 LabPak-NOR-EG
MONO# 0.5 x10^3/UL 0.0-0.6 LabPak-NOR-EG
LYMPH% 30.8 % 15.0-40.0 LabPak-NOR-EG
MONO% 7.1 % 0.0-10.0 LabPak-NOR-EG
ANC 5.2 x10^3/UL 1.5-6.5 LabPak-NOR-EG
GRAN% 62.1 % 39.0-78.0 LabPak-NOR-EG

IMMUNOFIXATION, SERUM (LabPak-FMO-AF)
IF INTERPRETATION - No monoclonal band observed

SERUM PROTEIN ELECTROPHORESI
PROTEIN, TOTAL 7.4 g/dL 5.9-8.4 LabPak-FMO-AF
ALBUMIN 45.9 Low % 48.1-59.5 LabPak-FMO-AF
ALPHA-1-GLOBULIN 3.5 % 2.3-4.9 LabPak-FMO-AF
ALPHA-2-GLOBULIN 12.1 % 6.9-13.0 LabPak-FMO-AF
BETA GLOBULIN 18.0 % 13.8-19.7 LabPak-FMO-AF
GAMMA GLOBULIN 20.5 % 10.1-21.9 LabPak-FMO-AF
A/G RATIO 0.9 CALC LabPak-FMO-AF
MSPIKE No monoclonal band observed

Specimen Date/Time 9/30/2015 4:16:00 AM
Gender: Female
Report Date: 10/2/2015 12:00 AM

Result Value Units Range Lab
IGG, IGA, IGM PANEL
IGA 389 High mg/dL 71-377 LabPak-FMO-AF
IGM 97 mg/dL 46-208 LabPak-FMO-AF
IGG 1362 mg/dL 716-1594 LabPak-FMO-AF

KAPPA LIGHT CHAINS
SERUM KAPPA 15.05 mg/L 3.30-19.40 LabPak-FMO-AF
LAMBDA LIGHT CHAINS
SERUM LAMBDA 9.62 mg/L 5.71-26.30 LabPak-FMO-AF

COMP METABOLIC PROFILE

SODIUM 142 mEq/L 133-145 LabPak-FMO-AF
POTASSIUM 4.1 mEq/L 3.3-5.1 LabPak-FMO-AF
CHLORIDE 104 mEq/L 98-108 LabPak-FMO-AF
CO2 29 mmol/L 22-33 LabPak-FMO-AF
BUN 8 mg/dL 6-23 LabPak-FMO-AF
CREAT 0.7 mg/dL 0.3-1.2 LabPak-FMO-AF
BUN/CREAT RATIO 11.4 CALC LabPak-FMO-AF
EGFR NON-AFR. AMER 104 ML/MIN 60-200 LabPak-AF
EGFR AFRICAN AMER 126 ML/MIN 60-200 LabPak-AF
CALCIUM 10.4 mg/dL 8.4-10.6 LabPak-FMO-AF
ALBUMIN 4.2 g/dL 3.2-5.2 LabPak-FMO-AF
GLOBULIN 3.4 g/dL 1.7-3.7 LabPak-FMO-AF
A/G 1.2 CALC 1.1-2.5 LabPak-FMO-AF
ALK PHOS 92 U/L 39-147 LabPak-FMO-AF
ALT 56 High U/L 0-31 LabPak-FMO-AF
AST 27 U/L 0-31 LabPak-FMO-AF
TOTAL BILI 0.40 mg/dL 0.0-1.0 LabPak-FMO-AF
GLUCOSE 98 mg/dL 70-105 LabPak-FMO-AF
TOTAL PROTEIN 7.6 g/dL 5.9-8.4 LabPak-FMO-AF

LDH
LDH 168 U/L 94-250 LabPak-FMO-AF

BETA-2- MICROGLOBULIN, SERUM
B2M 1.750 ug/mL 0.002-2.700 LabPak-FMO-AF

VITAMIN B-12 (ABBOTT)
B12 346 pg/mL 211-911 LabPak-FMO-CB

SERUM FREE LIGHT CHAINS
SERUM KAPPA 15.05 mg/L 3.30-19.40 LabPak-FMO-AF
SERUM LAMBDA 9.62 mg/L 5.71-26.30 LabPak-FMO-AF
KAPPA/LAMBDA, FREE 1.56 CALC 0.26-1.65 LabPak-FMO-AF

Any help on if multiple myeloma is possible would be helpful. I question cause I have no mspike, and my light chains seem to be pretty normal. Thanks again.

[JPC]

Re: Anxious about lab results, possible multiple myeloma

by JPC on Tue Oct 20, 2015 5:41 pm

Hello Rebecca:

As you said, you have no M-spike and your kappa, lambda, and K/L are all good. Based on the units that they reported the kappa and lambda in, I am guessing that you might be from Canada, as they are not the units typically posted in the US.

The following is based on my readings and research, and I am not a doctor nor qualified to give any type of medical opinion. But here is some basic info. Having multiple myeloma without an M-spike or elevated light chains is possible. It is called nonsecretory multiple myeloma. Non­secretory for newly diagnosed, however, is rare. Off the top of my head, it's in the 1% or 2% range. It becomes somewhat more common on relapse of multiple myeloma, but is very rare for newly diagnosed multiple myeloma.

I think you are correct in that your issues could possibly explained by multiple myeloma, but keep in mind that there are many other things that could cause them as well, so you need to keep an open mind at this point. If you are seeing a hematologist or myeloma specialist, however, I think there is one thing you can potentially do. You need to confirm this with your doctor, but I believe that if you are nonsecretory, in most cases you do show up positive in a bone marrow biopsy (BMB). So if you do the BMB, and you are negative, that would probably rule out multiple myeloma.

I would even hedge on that in that I think I recall reading about a couple of very rare cases where they did not have a positive for a BMB, but had evidence of a bone tumor. Multiple myeloma sometimes comes in patches, and you can randomly hit a clean spot when doing the BMB. But if you came up negative on the BMB, and in the absence of an M-spike and kappa, lambda issues, that would lead you towards looking at something else to explain your issues.

Good luck.