[dolphins4life]

Could these lab results indicate myeloma?

by dolphins4life on Thu Jan 23, 2014 11:56 am

Hi, I am new to this site and just received some blood work back and I am confused as to what the results reflect.

IMMUNOFIXATION SERUM.
INTERPRETATION
Two faint IgG (lambda) monoclonal Immunoglobulins are detected.

I am rather concerned after doing some prelim research on what this means.

Other blood work:
CARDIOLIPIN AB (IGM) - 19 (Indeterminate 13-20, low to medium 21-80, > 80 High Positive)

Lab Results:

BUN 11          - Normal
Creatine        - Normal
CALCIUM         - Normal
Protein Total   - Normal
ALBUMIN         - Normal
GLOBULIN        - Normal
AST             - Normal
ALT             - Normal
Creatine Kinase - LOW


I had numerous CT scans / X-rays over the past 12 years and I am worried that they may have caused me to have something serious. I know there's a lot of radiation, but the symptoms that occurred in the past warranted CT scans. So, what do you do? Know what I mean?

Anyway, I am now worried that maybe I have myeloma.

Can anyone tell me what other blood tests I should get to test for this. My primary has told me to not worry about this, but that is clearly easier said then done. Any help and advice would be greatly appreciated.

[Multibilly]

Re: Could these lab results indicate myeloma?

by Multibilly on Thu Jan 23, 2014 12:53 pm

You don't say why you've had so many PET/CT scans over the years.

Given you had a couple of faint bands show up on your immunofixation, it would be prudent if your doc ran some additional tests the next time you are scheduled for labwork, IMHO. At a minimum I would ask your doc if he could also run a Serum Protein Electrophoresis (SPEP) test at that time. That will measure the actual level of monoclonal proteins in your blood...and they are cheap and easy to do

If you want to run a more complete set of tests for multiple myeloma, you would get all of the tests outlined in the LABORATORY TESTS section listed here.

https://myeloma.org/ArticlePage.action?tabId=1&menuId=322&articleId=3177&aTab=-1

I wouldn't worry about this right now and would just ask your doc to put a reminder in your patient folder to do some follow up the next time you see him/her.

[Wayne K]

Re: Could these lab results indicate myeloma?

by Wayne K on Thu Jan 23, 2014 2:05 pm

I wouldn't be overly concerned about the x-rays. I had lung cancer 12 years ago and prostate 10 years ago. I've had radiation for the prostate and more chest x rays than I can count and I have been assured by more than one source that it shouldn't be a worry.

I link my multiple myeloma to something else because my sister passed from it and had no issues with radiation from a medical issue.

[dolphins4life]

Re: Could these lab results indicate myeloma?

by dolphins4life on Fri Jan 24, 2014 10:01 am

Thanks so much for your reply. I am really depressed. About 4 months ago, I started to develop bilateral thigh pain and could not figure out why. I had nerve conduction and EMG testing and everything came back normal. My left hand looks like it's from a 95 year old ( I am 48) and my elbow is painful (not sure if this is bone pain, but it feels like it). The sensitivity in both my hands is incredible. I cannot grab something REALLY hard without there being a burning type of pain. My left ankle had a small indentation that the doctors could not figure out, and now I get these blood results back and I am wondering if these symptoms that I am experiencing are from multiple myeloma or MGUS.

Is this curable if you catch it early enough? I am really depressed, I have a 1 year old (who now) may not even know his father. Could this be lymphoma or leukemia? Everything on the Internet seems to give a median age survival rate of 5 years. I am lost and depressed and will get the doctor to order the tests, but I am feeling bummed out.

[lys2012]

Re: Could these lab results indicate myeloma?

by lys2012 on Fri Jan 24, 2014 12:03 pm

Hi I just wanted to say don't worry too much about the 5 year statistic. It is really outdated now. There are new treatments, and according to my doctor 10 years is sort of what they are saying for normal risk myeloma, and even that is just a guesstimate.

Other the thigh pain, what you are describing in joints and your hands is not really what is normally described as "bone pain". The bone pain in myeloma is often in the bones that are still active with bone marrow, so all around your spine, ribs, hips, pelvis, shoulders upper arms and legs. and the pain is not in the joint but in the actual bone. kind of hard to describe.

Have you had any testing for autoimmune issue like arthritis?

One thing that jumps out at me is your blood protein is normal. When I was diagnosed my protein was about 10 times higher then normal! So I would not guess you have a myeloma issue going on.

Have you had a CBC blood test? Anemia and low counts are common in myeloma and other blood cancers. If you have normal blood counts then that is a good sign.

[Dr. Edward Libby]

Re: Could these lab results indicate myeloma?

by Dr. Edward Libby on Sat Jan 25, 2014 1:13 pm

Hello from foggy Seattle,

Right now you do not have enough information to be confident of whether you have MGUS, smoldering (asymptomatic) myeloma, or symptomatic myeloma. Having said that, I suspect this is MGUS. Further testing that is needed (at a minimum) includes the following:

1. Serum free light chains
2. 24 hour urine collection for Bence Jones proteins
3. Skeletal survey (plain x-rays of your major bones)

If there is still uncertainty after these tests a complete bone marrow biopsy would answer the question with certainty.

Complete evaluation of patients for MGUS versus symptomatic myeloma should probably be performed by a hematologist/oncologist. Good luck with this. I think everything will turn out alright for you but more testing is still needed.

[dolphins4life]

Re: Could these lab results indicate myeloma?

by dolphins4life on Mon Feb 03, 2014 8:50 am

Thanks for all of your comments, especially Dr. Libby.

I have a quick follow up. I went ahead and got the following tests done at QUEST Diagnostics.

1. SPEP
2. UPEP
3. Light Assay - Urine

I should have the results tomorrrow (2/4/14). However, my question is about the Skeletal Survey. What major bones would make up this survey? I had recent MRI's (10/2013) of Lumbar, Thoracic, Cervical, and Brain. I also had a CT scan of my Abdomen (including Pelvis). I am wondering what X-rays I should request. X-Rays of pelvis, shoulders and legs?

The MRI's were a result of a nagging pain in both of my thighs. I have had EMG's and NCV's which all turned out to be pretty much normal. My other question is: could the MGUS cause this dull aching pain in both my thighs (neuropathy)?

Anyway, thank you very much for your responses.

[Multibilly]

Re: Could these lab results indicate myeloma?

by Multibilly on Mon Feb 03, 2014 9:05 am

I'm a little confused by your response. You said you ordered the lab tests and that your are also ordering the skeletal survey. Aren't you working with an oncologist, and hopefully one that specializes in multiple myeloma that would actually order and interpret these tests? Maybe I'm just misinterpreting your comments, but you really can't/shouldn't diagnose and interpret this disease on your own.

Having said that, a skeletal survey covers your entire body with the exception of your hands and feet.

[dolphins4life]

Re: Could these lab results indicate myeloma?

by dolphins4life on Mon Feb 03, 2014 1:28 pm

Thanks for your reply. Sorry. I went to my GP to get the tests that were recommended by Dr. Libby so that I could then get the referral to a hematologist/Oncologist from my GP. I am not qualified to interpret the results. The other issue is that I do not know of any Oncologist that specializes in multiple myeloma in South Florida. I'll try looking within this site. I am very happy that I found this site. Very well done, and the replies are very quick. Thanks again for your help.

What about the Neuropathy issue. My hands are so sensistive and my thighs feel extrememly tired and heavy when I walk a very short distance. I am wondering if this could be caused by MGUS / multiple myeloma? I have had EMG's and NCV studies done and nothing can identify why my legs hurt when I stand or walk for a short distance. Thanks again for your help.

[Multibilly]

Re: Could these lab results indicate myeloma?

by Multibilly on Mon Feb 03, 2014 1:57 pm

If you are in South Florida, I would reach out to Pat Killingsworth at pat [{at}] helpwithcancer {[dot]} org for recommendations on who to see. He is a patient columnist for the Beacon and he lives in S. Florida.

Peripheral neuropathy can be a side effect of the disease itself,, but that really needs to be tested and evaluated by a doc.