I don't know how to figure out my husband's M protein/M spike and how bad the number is. Can anyone help? The test called Total Protein and Protein Electrophoresis w/ Scan shows these numbers:
Total protein 8.9
Albumin 4.3
Alpha 1 Globulins .2
Alpha 2 Globulins .8
Beta Globulins 3.4
Gamma Globulins .2
Abnormal Protein Band 1 3.0
Immunoglobulin A 20
Immunoglobulin G 2980
Immunoglobulin M 9
Free Kappa, Serum 414.8 mg/L
Free Lambda, Serum 2.6
Free Kappa/Lambda Ratio 159.54
2nd question: 8% clonal plasma cell population showing on he flow cytometry and 30-40% on the bone marrow morphology. Which one is the number to use when looking at staging? The bone marrow morphology actually says: Normocellular marrow with maturing trilineage hematopoisis with approx. 30-40% clonal plasma cells(IGG Kappa), consistent with plasma cell myeloma. Thank you so much for your help!
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Re: Diagnosed last month-two questions
I don't know if I can help you but I do know not everyone has m-spikes. When I was diagnosed I was told they were tracking my myeloma by my lambda free light chains which were 1220 at the time. My kappa light chains were normal (your kappa numbers are high and your lamba numbers are within normal range). I've had trouble understanding my numbers when I compare to others on this site but I did find a good pdf pamphlet I downloaded from the Canadian Myeloma society (http://www.myelomacanada.ca/en/default.htm) (go to the right side of the page and download the myeloma handbook). It tells about the different kinds of myeloma, staging, etc, in pretty clear understandable language.
For example "Although a high level of M protein in the blood is a hallmark of myeloma, about 15 - 20 % of patients produce only the light chain portion of the immunoglobulin. These are referred to as free light chains because they lack the heavy chain portion of the M protein. Light chain proteins are also referred to as Bence-Jones proteins, after the physician and chemist who discovered them in the urine of myeloma patients."
Maybe this will help. It will certainly help you when you ask the doc about what the numbers mean. good luck.
FYI- just over one year later after chemo and a auto stem cell transplant I am in complete remission with no detectable myeloma present. When first diagnosed I had 80-90% myeloma in my bone marrow biopsy, 50% kidney function, multiple lesions -- stage 3 according to the docs. Don't lose hope.
For example "Although a high level of M protein in the blood is a hallmark of myeloma, about 15 - 20 % of patients produce only the light chain portion of the immunoglobulin. These are referred to as free light chains because they lack the heavy chain portion of the M protein. Light chain proteins are also referred to as Bence-Jones proteins, after the physician and chemist who discovered them in the urine of myeloma patients."
Maybe this will help. It will certainly help you when you ask the doc about what the numbers mean. good luck.
FYI- just over one year later after chemo and a auto stem cell transplant I am in complete remission with no detectable myeloma present. When first diagnosed I had 80-90% myeloma in my bone marrow biopsy, 50% kidney function, multiple lesions -- stage 3 according to the docs. Don't lose hope.
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mowgli18 - Name: Mowgli18
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: March 2011
- Age at diagnosis: 51
Re: Diagnosed last month-two questions
I was diagnosed with Light Chain Myeloma in Feb of 2009 and had a CR. Light Chain Myeloma generlaly responds well to VRD (Velcade Revlimid Dexamethazone). I did not have a SCT but have maintained a CR since June 2009. I am still on VRD but at reduced amounts and extended intervals between treatments.
Ron Harvot
Ron Harvot
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Ron Harvot
Re: Diagnosed last month-two questions
Hello from rainy, cold and gray Seattle !
The serum free kappa light chains are elevated at 414 and the kappa/lambda light chain ratio is elevated at 159. This tells me that his myeloma plasma cells are still there and producing the abnormal light chain.
I cannot discern what the SPEP result is.
The thing to pay attention to in the bone results is the percentage of plasma cells by morphology (or immunohistochemistry). Flow cytomtery of the bone marrow sample generally underestimates the amount of plasma cells.
Always ask the oncologist what the "myeloma spike" is doing. Is the spike going up or down ? The spike can be measured in the blood with serum protein electrophoresis (SPEP) and in the urine with a 24 hour collection of urine for urine protein electrophoresis (UPEP). The abnormal light chains can also be measured in the blood with a serum free light chain test.
I wish you and your husband all the best.
The serum free kappa light chains are elevated at 414 and the kappa/lambda light chain ratio is elevated at 159. This tells me that his myeloma plasma cells are still there and producing the abnormal light chain.
I cannot discern what the SPEP result is.
The thing to pay attention to in the bone results is the percentage of plasma cells by morphology (or immunohistochemistry). Flow cytomtery of the bone marrow sample generally underestimates the amount of plasma cells.
Always ask the oncologist what the "myeloma spike" is doing. Is the spike going up or down ? The spike can be measured in the blood with serum protein electrophoresis (SPEP) and in the urine with a 24 hour collection of urine for urine protein electrophoresis (UPEP). The abnormal light chains can also be measured in the blood with a serum free light chain test.
I wish you and your husband all the best.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
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