Hello to everyone on this forum,
I have been reading and researching this site for 3 days but still need some help. My father is in his early 60's and has had some blood tests done that don't read too well. Symptoms are aching bones/joints, lethargy, and a very swollen knee. He has been given appointments to have a bone marrow biopsy and a skeletal survey next week.
His blood tests are as follows: Protein electrophoresis showed an IgG monoclonal protein 14 g/l (kappa light chains 53 mg/l, lambda light chains 12.3 mg/l, kappa/lambda ratio 4.31). His urine test shows no protein.
Can anyone please help me understand these results?
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Re: Blood test results - what do they mean?
Forgot to say, please don't be afraid of being truthful, because I think I already have worked out the outcome.
Re: Blood test results - what do they mean?
Hi Jinny,
Welcome to the forum.
First, a monoclonal protein (M-spike) level of 14 g/L (1.4 g/dL) is not that high. So, that's good news.
I assume these are FREE lambda and kappa light chain measurements taken from a blood sample. Given the kappa and lambda values are in range, but the kappa/lambda ratio is high, this "could" suggest a monoclonal gammopathy with bone marrow suppression.
These overall M-spike and free light chain levels "could" be associated with a diagnosis of MGUS or smoldering multiple myeloma (or some other plasma cell disorder). But a diagnosis will really depend on the outcome of the skeletal survey, the bone marrow biopsy, and also what his calcium, creatinine, and hemoglobin levels are.
Given he has some sort of monoclonal gammopathy, it's always best to seek out a top multiple myeloma specialist when getting diagnosed. If you let us know what city he is in, folks on the forum can recommend some specialists.
Hope this helps.
Welcome to the forum.
First, a monoclonal protein (M-spike) level of 14 g/L (1.4 g/dL) is not that high. So, that's good news.
I assume these are FREE lambda and kappa light chain measurements taken from a blood sample. Given the kappa and lambda values are in range, but the kappa/lambda ratio is high, this "could" suggest a monoclonal gammopathy with bone marrow suppression.
These overall M-spike and free light chain levels "could" be associated with a diagnosis of MGUS or smoldering multiple myeloma (or some other plasma cell disorder). But a diagnosis will really depend on the outcome of the skeletal survey, the bone marrow biopsy, and also what his calcium, creatinine, and hemoglobin levels are.
Given he has some sort of monoclonal gammopathy, it's always best to seek out a top multiple myeloma specialist when getting diagnosed. If you let us know what city he is in, folks on the forum can recommend some specialists.
Hope this helps.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Blood test results - what do they mean?
Hi Multibilly,
Thank you for the response. In answer to your question, yes the levels are from a blood sample.
As you've probably guessed, we are both new to all of this and any information we can gather is a bonus. We are in England and the blood test was originally taken for my father's painful and swollen knee and painful hands. I don't have any of his other blood results to hand unfortunately.
His biopsy and skeletal survey are next week so hopefully we will get answers sooner rather than later.
Once again, thank you for your input, it's much appreciated!
Thank you for the response. In answer to your question, yes the levels are from a blood sample.
As you've probably guessed, we are both new to all of this and any information we can gather is a bonus. We are in England and the blood test was originally taken for my father's painful and swollen knee and painful hands. I don't have any of his other blood results to hand unfortunately.
His biopsy and skeletal survey are next week so hopefully we will get answers sooner rather than later.
Once again, thank you for your input, it's much appreciated!
Re: Blood test results - what do they mean?
It sounds like you are concerned that he may have multiple myeloma. I agree with Multibilly in the possible diagnosis of MGUS or smoldering myeloma. I also agree that it would appear they he has some form of monoclonal gammopathy that will require further tests such as a bone scan and bone marrow biopsy to make a final diagnosis.
Here is a link to the newest criteria for the diagnosis of multiple myeloma:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
You will note that serum free light chain tests have to have measurements of 100 or greater in both the involved chain and the ratio. Your father's numbers are well below those (kappa chain of 53 and ratio of 4.31)
What is interesting is that the new criteria do not put focus on the size of the M-spike.
Here is a link to the newest criteria for the diagnosis of multiple myeloma:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
You will note that serum free light chain tests have to have measurements of 100 or greater in both the involved chain and the ratio. Your father's numbers are well below those (kappa chain of 53 and ratio of 4.31)
What is interesting is that the new criteria do not put focus on the size of the M-spike.
-
Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Blood test results - what do they mean?
Hi Ron,
Yes you're right, I am concerned he has multiple myeloma. I need to read up on MGUS or smoldering myeloma. I'm new to this so I'm not sure about the M-spike values.
We are just keeping our fingers crossed that the bone scan and bone marrow biopsy come back clear. To be honest I am besides myself with worry.
Thank you so much for your input, and I will read the links with interest.
Yes you're right, I am concerned he has multiple myeloma. I need to read up on MGUS or smoldering myeloma. I'm new to this so I'm not sure about the M-spike values.
We are just keeping our fingers crossed that the bone scan and bone marrow biopsy come back clear. To be honest I am besides myself with worry.
Thank you so much for your input, and I will read the links with interest.
Re: Blood test results - what do they mean?
Hi, Multibilly,
I have more blood results from my father. He has had a bone scan and a biopsy, but we are awaiting results.
Haemoglobin 135 g/l
Creatinine 71 umol/l
IgG kappa monoclone 14. g/l no immune paresis
Beta-microglobulin 1.68 mg/l
LDH Awaited
Serum free light chain ratio 4.31
Bence-Jones NAD
WBC 6.8 x 10/l
EGFR>60 ml/min
Platelets 228 x 10l
Calcium corrected 2.26 mol/l
I think I read these as good, am I correct?
Cheers
I have more blood results from my father. He has had a bone scan and a biopsy, but we are awaiting results.
Haemoglobin 135 g/l
Creatinine 71 umol/l
IgG kappa monoclone 14. g/l no immune paresis
Beta-microglobulin 1.68 mg/l
LDH Awaited
Serum free light chain ratio 4.31
Bence-Jones NAD
WBC 6.8 x 10/l
EGFR>60 ml/min
Platelets 228 x 10l
Calcium corrected 2.26 mol/l
I think I read these as good, am I correct?
Cheers
Re: Blood test results - what do they mean?
Jinny,
You should look at your lab results and see what is considered to be the normal range for each value and whether each value is in range or not. It doesn't seem like the creatinine, hemoglobin and calcium levels are out of range (which is good), but every lab has different ranges for what they consider to be "normal".
However, what jumps out at me is the slightly out-of-range serum free light chain ratio of 4.31. This value is not normal and goes along with the fairly low 14 g/L (1.4 g/dL) M-spike and the earlier comments that this may very well be a case of MGUS or smoldering myeloma (the bone marrow biopsy will help make the determination between the two diagnoses).
Again, folks on this forum would suggest seeking out a top myeloma specialist to verify a diagnosis and to suggest any further testing such as radiological imaging, etc.
You should look at your lab results and see what is considered to be the normal range for each value and whether each value is in range or not. It doesn't seem like the creatinine, hemoglobin and calcium levels are out of range (which is good), but every lab has different ranges for what they consider to be "normal".
However, what jumps out at me is the slightly out-of-range serum free light chain ratio of 4.31. This value is not normal and goes along with the fairly low 14 g/L (1.4 g/dL) M-spike and the earlier comments that this may very well be a case of MGUS or smoldering myeloma (the bone marrow biopsy will help make the determination between the two diagnoses).
Again, folks on this forum would suggest seeking out a top myeloma specialist to verify a diagnosis and to suggest any further testing such as radiological imaging, etc.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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