My 55-year old hubby has not been diagnosed yet, but the oncologist suggested multiple myeloma or lymphoma. I'm trying to understand which lab results matter and which to ignore, but so many results are too high or too low that I'm confused. We go for a bone marrow biopsy in 2 days. The oncologist says those results will take 10 days.
Please give me any suggestion. It's a longer story, we have been waiting 8 weeks so far for a diagnosis (our fault, not the doc) and I would love any suggestions.
% Neutr 38.8 (40.0-70.0)
%Lymph 59.6 (20.0-50.0)
T. Protein 13.5 (6.1-7.9)
Albumin 2.5 (3.6-5.1)
Globulin 11.0 (1.9-3.7)
Alka Phos 39 (40-115)
SED Rate 130 (0-20)
WBC 3.6 (3.8-10.8)
RBC 2.6 (4.2-5.8)
HGB 8.6 (13.2-17.1)
HCT 26.3 (38.5-50.0)
MCV 102.9 (80.0-100.0)
MCH 33.6 (27.0-33.0)
IgG 11570 (700-1700) not a typo
Creatinine within range
Calcium 8.0 (8.5-10.5)
Sodium 126 (136-146)
Lambda FLC 1.3 (6.1-29.7)
Kappa FLC 30.4 (3.9-22.5)
K/L Ratio 23.4 (0.3-1.7)
previous Kappa & Lambda were in mg/dL
Kappa 804 (74-295)
Lambda 5 (32-156)
Vit B12 1301 (180-914)
Alpha1 Globulin within range
Alpha2 Globulin within range
Beta1 Globulin within range
Beta2 Globulin 0.1 (0.2-0.5)
Gamma Globulin 8.2 (0.8-1.7)
Abnormal Protein Band 1 7.9 (no range given, maybe none?)
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7 posts
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wekebu - Name: Wendy
- Who do you know with myeloma?: Hubby
- When were you/they diagnosed?: Jan 2016
- Age at diagnosis: 55
Re: Do these lab results indicate multiple myeloma?
P.S. - He has no symptoms, and I omitted some results that were within normal range and didn't seem relevant.
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wekebu - Name: Wendy
- Who do you know with myeloma?: Hubby
- When were you/they diagnosed?: Jan 2016
- Age at diagnosis: 55
Re: Do these lab results indicate multiple myeloma?
Looking at this blood work, the thing that jumps out at me the most is the hemoglobin level. 8.6 is pretty low. Your husband must be feeling pretty weak, would be my guess. I am not sure if this is myeloma, however, his blood work is certainly suggestive of something of a hematological nature. You mentioned an abnormal protein band. Is there anything on his blood work that says "M-spike?"
FYI, with hemoglobin this low, some doctors would transfuse him. Why have you delayed pursuing diagnosis and treatment? I am sure there is a good reason, but it is imperative that he get a proper diagnosis and begin therapy with the appropriate agents.
Good luck, and please let us know what transpires. If you need referrals to multiple myeloma specialists, please let us know where you are. There are many on the forum who can make recommendations.
FYI, with hemoglobin this low, some doctors would transfuse him. Why have you delayed pursuing diagnosis and treatment? I am sure there is a good reason, but it is imperative that he get a proper diagnosis and begin therapy with the appropriate agents.
Good luck, and please let us know what transpires. If you need referrals to multiple myeloma specialists, please let us know where you are. There are many on the forum who can make recommendations.
Re: Do these lab results indicate multiple myeloma?
Your husband's kappa / lambda ratio of 23.4 is of concern. However, I am not a doctor.
When is your husband's next onco / haematologist appointment?
When is your husband's next onco / haematologist appointment?
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: Do these lab results indicate multiple myeloma?
Welcome to the forum, Wendy.
You husband's doctor will need to do some additional testing, in particular the bone marrow biopsy that is planned. Also, it would be a good idea to have xray or MRI imaging done of your husband's bones to see if there are any signs of bone lesions (if such imaging hasn't already been done).
Based on those results and the test results you've already shared with us, your husband's doctor will make an initial diagnosis. The doctor will make that diagnosis based on a lot more information than we have here, and a lot more experience than we have -- including an understanding of diseases other than multiple myeloma that could lead to the lab results your husband has.
That having been said, and keeping in mind that I'm not a physician, I will say that, unfortunately, the results you've shared with us so far do point in the direction of a multiple myeloma diagnosis.
As you noted, your husband's IgG is VERY elevated. The reason it is so elevated seems to be because of a very high monoclonal protein level (M-spike), as indicated by the "abnormal protein band 1" of 7.9 g/dL. (I'm assuming the units are g/dL because you are in the U.S.)
People who are healthy, and do not have multiple myeloma, do not have an abnormal protein band. The "reference range" for the test is "0", or "none", as you suspected.
In your husband's case, something is causing him to produce monoclonal (unhealthy) IgG, which is being picked up as the "abnormal protein band" and reflected in the elevated IgG level. His IgG is now composed of two parts -- healthy IgG, and unhealthy (monoclonal, abnormal) IgG.
The elevated kappa/lambda free light chain level also suggests the presence of a plasma cell disorder such as multiple myeloma.
The IgG, abnormal protein band, and free light chain results are reflected, as well, in the very low hemoglobin level that Ellen highlighted.
I hope very, very much that what I've just written is wrong, and that your husband's tests got mixed up, or there is some other benign explanation for the results you've shared with us. It is very important, however, to keep moving forward with the testing and diagnosis, as an M-spike of 7.9 g/dL is quite high, and if the correct diagnosis is multiple myeloma, he should start treatment very soon.
To understand the criteria for a multiple myeloma diagnosis, see this article:
https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/
To see what symptoms are typically seen in people when they are diagnosed with multiple myeloma, see this posting here in the forum:
https://myelomabeacon.org/forum/most-common-symptoms-at-multiple-myeloma-diagnosis-t6280.html
Please keep us posted on additional information that you find out, and do not hesitate to let us know if you have more questions we may be able to answer.
Best wishes,
Terry
You husband's doctor will need to do some additional testing, in particular the bone marrow biopsy that is planned. Also, it would be a good idea to have xray or MRI imaging done of your husband's bones to see if there are any signs of bone lesions (if such imaging hasn't already been done).
Based on those results and the test results you've already shared with us, your husband's doctor will make an initial diagnosis. The doctor will make that diagnosis based on a lot more information than we have here, and a lot more experience than we have -- including an understanding of diseases other than multiple myeloma that could lead to the lab results your husband has.
That having been said, and keeping in mind that I'm not a physician, I will say that, unfortunately, the results you've shared with us so far do point in the direction of a multiple myeloma diagnosis.
As you noted, your husband's IgG is VERY elevated. The reason it is so elevated seems to be because of a very high monoclonal protein level (M-spike), as indicated by the "abnormal protein band 1" of 7.9 g/dL. (I'm assuming the units are g/dL because you are in the U.S.)
People who are healthy, and do not have multiple myeloma, do not have an abnormal protein band. The "reference range" for the test is "0", or "none", as you suspected.
In your husband's case, something is causing him to produce monoclonal (unhealthy) IgG, which is being picked up as the "abnormal protein band" and reflected in the elevated IgG level. His IgG is now composed of two parts -- healthy IgG, and unhealthy (monoclonal, abnormal) IgG.
The elevated kappa/lambda free light chain level also suggests the presence of a plasma cell disorder such as multiple myeloma.
The IgG, abnormal protein band, and free light chain results are reflected, as well, in the very low hemoglobin level that Ellen highlighted.
I hope very, very much that what I've just written is wrong, and that your husband's tests got mixed up, or there is some other benign explanation for the results you've shared with us. It is very important, however, to keep moving forward with the testing and diagnosis, as an M-spike of 7.9 g/dL is quite high, and if the correct diagnosis is multiple myeloma, he should start treatment very soon.
To understand the criteria for a multiple myeloma diagnosis, see this article:
https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/
To see what symptoms are typically seen in people when they are diagnosed with multiple myeloma, see this posting here in the forum:
https://myelomabeacon.org/forum/most-common-symptoms-at-multiple-myeloma-diagnosis-t6280.html
Please keep us posted on additional information that you find out, and do not hesitate to let us know if you have more questions we may be able to answer.
Best wishes,
Terry
Re: Do these lab results indicate multiple myeloma?
Hi,
I think if hubby felt poorly, he would be more patient with the testing procedures. However, he feels very healthy. Works full time and Ice skates a few times weekly for 2 hours each time (I want him to relax on the sofa and not stress his body).
Last week he had 2 more blood tests and a full skeletal survey. The bone marrow biopsy this week and an appointment with oncologist the week after.
As to the delay, hubby's problem was first noticed in an eye exam back in October. He had a routine blood test done in November. Then an appointment with his doc to discuss the results, and by the time another was taken and then an appointment with an oncologist, it was 3 weeks until the end of the year. We have a $6k deductible. So hubby wanted to wait until the new year.
Thank you very much for the replies and all the information. I knew it was going to be hard to answer my question, but I needed to reach out. I'm weepy when he's at work and put on my brave face when he's home. I only relate the good to him, yet try to be as informative as possible.
I'm so grateful for this forum, and the folks who take time to answer questions.
I think if hubby felt poorly, he would be more patient with the testing procedures. However, he feels very healthy. Works full time and Ice skates a few times weekly for 2 hours each time (I want him to relax on the sofa and not stress his body).
Last week he had 2 more blood tests and a full skeletal survey. The bone marrow biopsy this week and an appointment with oncologist the week after.
As to the delay, hubby's problem was first noticed in an eye exam back in October. He had a routine blood test done in November. Then an appointment with his doc to discuss the results, and by the time another was taken and then an appointment with an oncologist, it was 3 weeks until the end of the year. We have a $6k deductible. So hubby wanted to wait until the new year.
Thank you very much for the replies and all the information. I knew it was going to be hard to answer my question, but I needed to reach out. I'm weepy when he's at work and put on my brave face when he's home. I only relate the good to him, yet try to be as informative as possible.
I'm so grateful for this forum, and the folks who take time to answer questions.
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wekebu - Name: Wendy
- Who do you know with myeloma?: Hubby
- When were you/they diagnosed?: Jan 2016
- Age at diagnosis: 55
Re: Do these lab results indicate multiple myeloma?
So sorry you have found your way here, but it is a great place if you need it.
My husband was diagnosed in December by our PCP and, due to it being the week before the holidays, it was January 7th before we got to see the myeloma specialist. He was in acute kidney distress and admitted for a four-day hospital stay and now, after 4 cycles of cyclophosphamide, Velcade, and dexamethasone (CyborD), he is doing really well and kidney function is normal again.
He has IgA kappa myeloma as well and his IgA was 1804 on diagnosis and is now normal.
Try to breath and take each day as it comes. After 4 cycles of chemo, my husband is slated for a stem cell transplant. Myeloma is very treatable with many options open. I wish you and your husband well.
My husband was diagnosed in December by our PCP and, due to it being the week before the holidays, it was January 7th before we got to see the myeloma specialist. He was in acute kidney distress and admitted for a four-day hospital stay and now, after 4 cycles of cyclophosphamide, Velcade, and dexamethasone (CyborD), he is doing really well and kidney function is normal again.
He has IgA kappa myeloma as well and his IgA was 1804 on diagnosis and is now normal.
Try to breath and take each day as it comes. After 4 cycles of chemo, my husband is slated for a stem cell transplant. Myeloma is very treatable with many options open. I wish you and your husband well.
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
7 posts
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