[supersonic1]

Bone fractures when you have MGUS

by supersonic1 on Fri Feb 09, 2018 6:11 pm

Hi All,

First of all, I'd like to just say it's great to see this community here discussing anything myeloma- and MGUS-related. My dad has had MGUS for the past 10 years almost, and it's been stressful having to sometimes deal with this and the possibility of it progressing to multiple myeloma. I've been a lurker here and there and reading these posts have provided me a great level of comfort, so thank you!

As I mentioned, my dad has had MGUS for almost 10 years, He's 63 years old. His recent blood test last month showed his plasma level is 6 g/L (0.6 g/dL) and I believe this level has been pretty stable since he was first diagnosed with this. The rest of the levels look normal, but his white blood cells count is a little low.

Recently in the past month he started having a neck pain and lip twitching sometimes. He just did a test that showed a fracture in his neck, and the radiologist said 'pathological fracture perhaps due to metastasis or bone marrow infiltration'.

Do these fractures mean that my father's MGUS has progressed to multiple myeloma, or can people have MGUS and fractures without the disease necessarily having progressed to multiple myeloma?

I'm just trying to understand if fractures can happen when you have MGUS without necessarily meaning the disease has progressed to multiple myeloma. I really hope this is nothing serious .

Thanks!

[Multibilly]

Re: Bone fractures when you have MGUS

by Multibilly on Fri Feb 09, 2018 8:01 pm

Hi Supersonic,

If the fracture looks like it's due to metastasis (cancer) or bone infiltration, he should really be getting some follow up testing and imaging. Neither of those descriptions sounds like a fracture due to osteoporosis or another ailment associated with getting old. But then again, I'm not a doctor.

And just because his blood "plasma level" (I think you really meant to say "M-spike" or paraprotein) appears to be in the typical MGUS range, that doesn't necessarily mean that he may not be experiencing bone damage due to myeloma. If his fracture is due to his monoclonal gammopathy, then by definition, he would now be diagnosed with myeloma. A PET/CT or perhaps an MRI should be able to better confirm the nature of the fracture.

I'm by no means trying to alarm you, but I would suggest playing it safe and do a follow-up consult with the oncologist to figure out the next steps and to rule out myeloma.

[bodumene]

Re: Bone fractures when you have MGUS

by bodumene on Sat Feb 10, 2018 8:04 pm

I had MGUS for 3 or 4 years that I knew about, perhaps longer, and the ONLY reason I began treatment for multiple myeloma was because I started getting compression fractures in my spine. These occurred even though I was already taking an osteoporosis drug. Although my blood tests showed somewhat higher than normal results in certain areas (e.g., M-spike of 1.6 g/dl, or 16 g/l), these numbers alone would not have been high enough to suggest I begin treatment. I regarded myself as lucky that I got these fractures rather than any other multiple myeloma symptoms, because in general I was still very healthy. After less than a year of treatment I am in full remission.

As soon as I thought the MGUS might be developing into multiple myeloma, I got myself to an oncology specialist in blood cancers, and had a full set of tests. I would suggest the same for your Dad. I educated myself regarding the disease and the treatments (with the help of Multibilly's, and others', many extremely informative postings here in the forum), and as a result, I had a lot of faith in the treatment. This knowledge kept me from too much worrying. (I was more concerned with the side effects of the myeloma drugs, but I managed to survive them.) And now my blood tests are pretty much normal, and, as far as I know, I have not gotten any more fractures.

So my message is: educate yourself about what is likely to happen, and have faith in the treatment, should it prove necessary. Best of luck to you and your Dad.