Hello everyone,
I am new to this forum, and, until yesterday, I had never posted on a forum before, so please bear with me.
I was diagnosed in 2005 with IgA lambda light chain multiple myeloma. I have had two autologous SCTs (2006 & 2012), and both times I achieved a near complete response. I've been treated in the past with VAD and Velcade.
I am now 26 months out from my last SCT, and my numbers seem to be going up at least ten months faster than the last time.
On my last visit to my oncologist in April, my abnormal test results were as follows:
Iron Blood: 38 (50-175)
Lambda LCQ: 7.29 (0.57-2.63)
Kappa/Lambda Ratio 0.20 (0.26-1.65)
Hemoglobin Blood: 10.9 (11.8-16.0)
PCV Blood:34% (36-43)
MCV 68 (37.4-52.4)
Lymphs(ABS): 0.67 (1.10-3.50)
Mono (ABS) 1.47 (0.30-1.10)
IgA was normal at 415 (65-421)
I have no clue at all what all this stuff means:
Anisocytosis:2+
Poikilocytosis:2+
Microcytosis:2+
Polychromasia:2+
Elliptocytes:2+
Schistocytes:1+
Acanthocytes:1+
Tear Drop Cells:1+
Smudge Cells: Negative
WBC Comments: Neutrophils Vacuoles
Platelet Comments: Large Platelets present
I have been very tired for a quite a while now. My doctor had me do a colonoscopy, but everything was fine. I am post menopausal, and I am not bleeding from any other place that I am aware of. They put me on iron pills, but my iron dropped from 72 in January to 38 in April. They told me to double my pills, but I cannot tolerate the dosage. It makes my heart race, and my stomach burns.
Could all this mean my bone marrow is failing, and if so, what does that mean?
My main question, however, is about the lambda light chain quant: (7.29) and the kappa/lambda ratio(0.20). Does this mean that I am about to relapse?
My next appoint with my doctor isn't until July, and I would like to know the truth now. I try to research all this stuff on the Internet, but I cannot come up with any good answers, just a bunch of scary stuff. All I end up doing is worrying. I would rather know the truth, to be sure I'm worrying about the right thing, and then get the worrying over with.
Thank you for your time,
Mary
Forums
3 posts
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inky100 - Name: Mary
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2005
- Age at diagnosis: 43
Re: Do these lab results mean I may be relapsing?
It is not easy to make comments with one set of labs (meaning they need to be relative to the last set of labs). With myeloma you "always" want to keep track of your serum M-spike (SPEP) and immunofixation (IFE), 24 hour urine (UPEP& IFE), quantitative immunogloubulins (IgA in your case) and serum free light chains (SFLC - lambda and ratio as you have). Additionally, keep an eye of marrow function Hgb, kidney function (creatinine), and electrolyte balance (calcium), at a minimum.
Form what you have posted, we can say that you are mildly anemic with a Hgb of 10.9. This may be your new normal - especially after two transplants. Your iron is a bit low, which may also be contributing to the anemia. Generally, I would also check your ferritin and TIBC [total iron-binding capacity] to affirm iron deficiency. WIth a hemoglobin of 10.9, most people would not even know it (should not be symptomatic from it). If your iron is affecting you in that way, I would not double it, but i would discuss this with your doctor or his/her nurse/PA before changing.
Your lambda light chains and the kappa/lambda ratio do suggest that there may be a clonal paraprotein being produced. However, both of these are only mildly out of the normal range and may just represent fluctuations in labs from time to time. It will take another set of labs in 3 months when you see your oncologist. They may be normal next time. And even if slightly elevated, a lot of myeloma docs may continue to just monitor with a "serologic relapse" -meaning just in the blood and urine, but not symptomatic (no CRAB-I). Your IgA remains within normal limits. A good sign.
It will take a bit more time for you to know what is going on with your disease - next visit. I would hold tight and stay positive. Pleas keep us updated.
Form what you have posted, we can say that you are mildly anemic with a Hgb of 10.9. This may be your new normal - especially after two transplants. Your iron is a bit low, which may also be contributing to the anemia. Generally, I would also check your ferritin and TIBC [total iron-binding capacity] to affirm iron deficiency. WIth a hemoglobin of 10.9, most people would not even know it (should not be symptomatic from it). If your iron is affecting you in that way, I would not double it, but i would discuss this with your doctor or his/her nurse/PA before changing.
Your lambda light chains and the kappa/lambda ratio do suggest that there may be a clonal paraprotein being produced. However, both of these are only mildly out of the normal range and may just represent fluctuations in labs from time to time. It will take another set of labs in 3 months when you see your oncologist. They may be normal next time. And even if slightly elevated, a lot of myeloma docs may continue to just monitor with a "serologic relapse" -meaning just in the blood and urine, but not symptomatic (no CRAB-I). Your IgA remains within normal limits. A good sign.
It will take a bit more time for you to know what is going on with your disease - next visit. I would hold tight and stay positive. Pleas keep us updated.
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Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
Re: Do these lab results mean I may be relapsing?
Dr. Shain,
Thank you so much for your response. The fact that you and the other doctors who post on this board take the time to do this is greatly appreciated. My doctor is two hours away. When I go there, most of my labs are still pending, so I never get to talk to him face-to-face about the results until the next visit. I do see another oncologist locally occasionally, and he suggested that I take iron infusions. He seemed quite concerned, which, of course, concerned me. However, my doctor at Vanderbilt wants me to continue on the iron pills instead.
Thank you again. Your advice has helped take the edge off my worrying.
Have a good evening,
Mary
Thank you so much for your response. The fact that you and the other doctors who post on this board take the time to do this is greatly appreciated. My doctor is two hours away. When I go there, most of my labs are still pending, so I never get to talk to him face-to-face about the results until the next visit. I do see another oncologist locally occasionally, and he suggested that I take iron infusions. He seemed quite concerned, which, of course, concerned me. However, my doctor at Vanderbilt wants me to continue on the iron pills instead.
Thank you again. Your advice has helped take the edge off my worrying.
Have a good evening,
Mary
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inky100 - Name: Mary
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2005
- Age at diagnosis: 43
3 posts
• Page 1 of 1