Good Afternoon,
I went to a hematology / oncologist yesterday with my mother. She was complaining of hip pain and went for an MRI. The MRI showed abnormalities in her bone marrow. So her PCP took a ton of blood. When the results came in, she was sent to a "blood doctor."
So apparently she had an M-spike which was 200. He took some more blood and urine. We go back in about 2 weeks.
The doctor was fantastic at explaining everything; I just have one question. Does the small M-spike alone diagnose her as having multiple myeloma?
Warm Regards,
Sandra
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Concerned Daughter - Name: Sandra
- Who do you know with myeloma?: Mother
- When were you/they diagnosed?: 58
- Age at diagnosis: 58
Re: Does having an M-spike mean you have multiple myeloma?
Hi Sandra,
The short answer to your question is no. Having an M-spike does not automatically mean you have multiple myeloma.
Having an M-spike can mean that someone has a much more benign condition known as monoclonal gammopathy of undetermined significance (MGUS), which in most cases never progresses to a point where the person with it requires treatment for the disease.
An M-spike also could signify a condition known as smoldering multiple myeloma, which also is not generally treated, but often does progress to multiple myeloma (which generally IS treated).
There are also several other "plasma cell disorders" that involve having an M-spike. Some are less serious than multiple myeloma.
When you said your mother had an M-spike of 200, what were the units? Were they mg/dL?
There are rather clearly defined criteria for determining if someone has multiple myeloma, and they involve tests other than just the M-spike. The criteria are summarized in this article,
https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/
You also may want to check the "diagnostic criteria" section of the Wikipedia article about multiple myeloma,
https://en.wikipedia.org/wiki/Multiple_myeloma#Diagnostic_criteria
The criteria there are not as up to date as those in the article I listed, but they may help you understand all the criteria that are involved in making a multiple myeloma diagnosis. The description there is also good about clarifying how MGUS, smoldering myeloma, and multiple myeloma are related, yet different.
Two things to note about the Wikipedia article:
- It refers to the "M-spike" as "monoclonal protein" or "paraprotein." These are all words for the same thing.
- It uses units of g/L for measurements of the M-spike. In the U.S., g/dL, and sometimes mg/dL, are more commonly used for M-spike measurements. Here's the conversion between the different units: 10 g/L = 1 g/dL = 1000 mg/dL. So the key "cutoff" M-spike of 30 g/L equals 3 g/dL or 3000 mg/dL.
If you have additional questions, just let us know. Good luck!
The short answer to your question is no. Having an M-spike does not automatically mean you have multiple myeloma.
Having an M-spike can mean that someone has a much more benign condition known as monoclonal gammopathy of undetermined significance (MGUS), which in most cases never progresses to a point where the person with it requires treatment for the disease.
An M-spike also could signify a condition known as smoldering multiple myeloma, which also is not generally treated, but often does progress to multiple myeloma (which generally IS treated).
There are also several other "plasma cell disorders" that involve having an M-spike. Some are less serious than multiple myeloma.
When you said your mother had an M-spike of 200, what were the units? Were they mg/dL?
There are rather clearly defined criteria for determining if someone has multiple myeloma, and they involve tests other than just the M-spike. The criteria are summarized in this article,
https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/
You also may want to check the "diagnostic criteria" section of the Wikipedia article about multiple myeloma,
https://en.wikipedia.org/wiki/Multiple_myeloma#Diagnostic_criteria
The criteria there are not as up to date as those in the article I listed, but they may help you understand all the criteria that are involved in making a multiple myeloma diagnosis. The description there is also good about clarifying how MGUS, smoldering myeloma, and multiple myeloma are related, yet different.
Two things to note about the Wikipedia article:
- It refers to the "M-spike" as "monoclonal protein" or "paraprotein." These are all words for the same thing.
- It uses units of g/L for measurements of the M-spike. In the U.S., g/dL, and sometimes mg/dL, are more commonly used for M-spike measurements. Here's the conversion between the different units: 10 g/L = 1 g/dL = 1000 mg/dL. So the key "cutoff" M-spike of 30 g/L equals 3 g/dL or 3000 mg/dL.
If you have additional questions, just let us know. Good luck!
Last edited by TerryH on Fri Oct 30, 2015 3:58 pm, edited 1 time in total.
Re: Does having an M-spike mean you have multiple myeloma?
Hi Sandra
An m-spike alone is not enough to make a call on myeloma. Here are the key factors which doctors will look at:
a/ Size of the m-spike. Can you please give us the units of measure for the 200 you mention?
Note that the presence of an m-spike means there is a bad protein being produced, which usually the source of all the problems below. I will only refer to it as "protein" hereafter...
Another component related to this is how much of the bone marrows is the protein occupying.
b/ Presence of anemia only explained due to bone marrow dysfunction related to myeloma. They look at hemoglobin levels for this. Too much protein could crowd the marrow and prevent proper production and release of red blood cells, resulting in anemia.
c/ Presence of protein related kidney damage of dysfunction. Again, too much protein will put a strain on the kidneys and result in potential damage.
d/ Elevated calcium levels in the blood. As the protein gets produced in the marrow it damages the bones, which in turn release their calcium in the blood. This can have some impact on the body.
e/ Presence of bone damage through visualization of (usually) long bones, such as spine, ribs, ... The protein damaging the bone will cause holes. They usually visualize with normal x-rays or MRI/PET/CT if the amount of protein is high and if the patient complains of bone pain.
have a look at https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/to get all the values and measurements doctors will evaluate.
In absence of any the above an m-spike alone would flag pre-conditions such as MGUS (benign) or smoldering myeloma (asymptomatic myeloma). These are classified based on the amount of protein discovered and how much of it crowds the bone marrow.
Hope this helps.
Good luck!
An m-spike alone is not enough to make a call on myeloma. Here are the key factors which doctors will look at:
a/ Size of the m-spike. Can you please give us the units of measure for the 200 you mention?
Note that the presence of an m-spike means there is a bad protein being produced, which usually the source of all the problems below. I will only refer to it as "protein" hereafter...
Another component related to this is how much of the bone marrows is the protein occupying.
b/ Presence of anemia only explained due to bone marrow dysfunction related to myeloma. They look at hemoglobin levels for this. Too much protein could crowd the marrow and prevent proper production and release of red blood cells, resulting in anemia.
c/ Presence of protein related kidney damage of dysfunction. Again, too much protein will put a strain on the kidneys and result in potential damage.
d/ Elevated calcium levels in the blood. As the protein gets produced in the marrow it damages the bones, which in turn release their calcium in the blood. This can have some impact on the body.
e/ Presence of bone damage through visualization of (usually) long bones, such as spine, ribs, ... The protein damaging the bone will cause holes. They usually visualize with normal x-rays or MRI/PET/CT if the amount of protein is high and if the patient complains of bone pain.
have a look at https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/to get all the values and measurements doctors will evaluate.
In absence of any the above an m-spike alone would flag pre-conditions such as MGUS (benign) or smoldering myeloma (asymptomatic myeloma). These are classified based on the amount of protein discovered and how much of it crowds the bone marrow.
Hope this helps.
Good luck!
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Cedb
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