rbc low with 3.58
hct low with 34.9
rdw dxh high with 16.1
plt dxh high with 450
mpv dxh low with 6.9
mri =
there is diffuse heterogenous signal abnormality throughout the visualized marrow containing structures with several more focal T1 hypointense and T2 hyperintense lesions, specifically within the left aspect of the sacrum , right superior aspect of the L4 vertebral body, and at least two lesions within the right iliac bone, one of which measures approximately 9mm in greatest transaxial dimensions immediately adjacent to the sacroiliac joint anteriorly with a more ill-defined area of signal abnormality within the posterior aspect of the iliac bone more superiorly. Additional regions of more focal signal abnormaltiy involve the bilateral proximal femoral diaphyses. diffusely heterogeneous marrow signal, some of which reflect underlying anemia. Several more focal lesions withing the sacrum, right iliac bone, and bilateral proximal femurs are more concerning for focal myelomatous lesions.
Kappa light low with .27
lambda light high with 575
IgG low with 367
IgA high with 1888
IgM low with 42
serum proteinelectrophoresis =
Alpha 2 high with 1.1
Beta high with 2.9
Gamma low with .5
M-spike 1.4
total protein spe high with 8.5
FISH studies showed an abnormal karyotype with hyperdiploidy, monosomy 13, and IGH gene rearrangement. In multiple myeloma hyperdiploidy with trisomies 5,9,11 and 15 is associated with a good prognosis, however, the presence of monosomy 13 and IGH gene rearrangement puts the patient in a category of less favorable prognosis. FISH studies showed gains of chromosomes 5,9,11 and 15 in 29% of cells examined, consistent with a hyperdiploid karyotype. FISH was also positive for a deletion of chromosome 13 in 27% of cells wich is associated with secondary genetic changes in multiple myeloma. IGH gene rearrangement was observed in 17% of cells examined.
Abnormal bone marrow cells: 38% variable, size clonal plasma cells expressing CD38, CD45, CD56, CD117 and cytoplasmic Lambda. DNA analysis reveals 38% plasma cells with a DNA index = 1.37 with <1%proliferation.
Bone marrow =
<1% myeloblasts
3% hematogones
2% polyclonal b-cells , kappa/lambda ration = 1.9:1
5% small t-cells , CD4:CD8 ratio = 0.8:1
<1 % nk cells
2% monocytes
47% neutrophils
1% eosinophils
1% basophils
erythroid cells, CD45 cells T debris comrise the remaining events
Ctospin and aspirate smears demonstrate scattered atypical plasma cells with admixed myeloid and erythroid precursors.
normocytic/normochromic anemia present
rouleaux formation present
thrombocytosis present
The aspirate and bone marrow biopsy display 50% lambda clonal plasma cells.
overall celularity increased 60% increased for age
skeletal survey =
degenerative changes from C6 thru T1
two views of the thoracic spine whow suspicious lesion
degenerative changes are present with acute osseous abnormality
destructive lesions in the right humerus
degenerative change at acromioclavicular joint is shown
Well that's the test results print out I was given. I don't understand a word of it except that I have cancer. Can someone please help tell me what this means.
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Re: Don't understand my lab results at all - help?
I’m so sorry to hear about your situation.
I’m not a doctor, but the bottom line is it certainly does look like you have symptomatic IgA Lambda Multiple Myeloma…but you already know that.
I edited some of the more important data for you to concentrate on and monitor as you go through treatment. I won’t try to sugar coat the results.
You have bone lesions and bone marrow plasma greater than 30%. Either of these classifies you as “symptomatic”.
Depending on your hemaglobin level (I don’t see it listed here….Hemaglobin would show up as HgB, hg or hgb in your lab results), you may also be anemic based on your low RBC, HCT, etc.
• rbc low with 3.58
• hct low with 34.9
• normocytic/normochromic anemia present
Your Lambda light, IgA, M-spike and plasma cells in your bone marrow are all key indicators for the overall disease burden.
• lambda light high with 575
• IgA high with 1888
• M-spike 1.4
• Abnormal bone marrow cells: 38% variable
• The aspirate and bone marrow biopsy display 50% lambda clonal plasma cells.
You apparently have bone lesions, again a typical result of multiple myeloma
• at least two lesions within the right iliac bone,
• two views of the thoracic spine suspicious lesion
Note that chemo treatment will help address all of these issues as they are all related to your myeloma. If you haven’t already, you should also talk to your doc about medications to help strengthen your bones (Zometa, etc).
Your genetic results from your FISH study give you a mixed prognosis and will influence what treatments your doc may select. The good results in your FISH (hyperdiploidy, etc) don’t necessarily counter the less favorable results (monosomy 13, etc).
Best of luck to you. The new treatments and drugs for multiple myeloma are truly amazing and offer a lot of hope.
I’m not a doctor, but the bottom line is it certainly does look like you have symptomatic IgA Lambda Multiple Myeloma…but you already know that.
I edited some of the more important data for you to concentrate on and monitor as you go through treatment. I won’t try to sugar coat the results.
You have bone lesions and bone marrow plasma greater than 30%. Either of these classifies you as “symptomatic”.
Depending on your hemaglobin level (I don’t see it listed here….Hemaglobin would show up as HgB, hg or hgb in your lab results), you may also be anemic based on your low RBC, HCT, etc.
• rbc low with 3.58
• hct low with 34.9
• normocytic/normochromic anemia present
Your Lambda light, IgA, M-spike and plasma cells in your bone marrow are all key indicators for the overall disease burden.
• lambda light high with 575
• IgA high with 1888
• M-spike 1.4
• Abnormal bone marrow cells: 38% variable
• The aspirate and bone marrow biopsy display 50% lambda clonal plasma cells.
You apparently have bone lesions, again a typical result of multiple myeloma
• at least two lesions within the right iliac bone,
• two views of the thoracic spine suspicious lesion
Note that chemo treatment will help address all of these issues as they are all related to your myeloma. If you haven’t already, you should also talk to your doc about medications to help strengthen your bones (Zometa, etc).
Your genetic results from your FISH study give you a mixed prognosis and will influence what treatments your doc may select. The good results in your FISH (hyperdiploidy, etc) don’t necessarily counter the less favorable results (monosomy 13, etc).
Best of luck to you. The new treatments and drugs for multiple myeloma are truly amazing and offer a lot of hope.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Don't understand my lab results at all - help?
Quite a bit to go over there. The MRI is suggestive of multiple myeloma needing treatment or "symptomatic" multiple myeloma.
Would recommend discussing treatment options with your doctor.
Would recommend discussing treatment options with your doctor.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Don't understand my lab results at all - help?
My doctor says I'm high risk smoldering and has me in a trial study he's a part of. What is it that leads you to believe I may be full blown multiple myeloma and not smoldering?
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Obayan
Re: Don't understand my lab results at all - help?
This might help you better understand why I think you may not be smoldering.
If you meet any one of the "C.R.A.B. criteria," you are by definition "symptomatic" and are no longer smoldering.
So, if you indeed have multiple bone lesions (as suggested by the MRI), you may meet the "B" in CRAB and are therefore symptomatic and need treatment. In order to be a "B", the lesions must be due to multiple myeloma and not some other disease. I suggest you discuss this with your doctor.
What is your hemaglobin level (shows up as HGB, HB or HG on your lab tests)? This can help determine if you meet the "A" in the CRAB -- "Anemia."
What is your calcium level? This can help you determine if you meet the "C" in CRAB -- "Calcium"
Hope this helps.
If you meet any one of the "C.R.A.B. criteria," you are by definition "symptomatic" and are no longer smoldering.
So, if you indeed have multiple bone lesions (as suggested by the MRI), you may meet the "B" in CRAB and are therefore symptomatic and need treatment. In order to be a "B", the lesions must be due to multiple myeloma and not some other disease. I suggest you discuss this with your doctor.
What is your hemaglobin level (shows up as HGB, HB or HG on your lab tests)? This can help determine if you meet the "A" in the CRAB -- "Anemia."
What is your calcium level? This can help you determine if you meet the "C" in CRAB -- "Calcium"
Hope this helps.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Don't understand my lab results at all - help?
HGB DXH was normal with 12.1
Calcium was normal with 9.4
Creatinine was 0.8
The MRI did show bone lesions but doesn't say from what. I assumed it was from the multiple myeloma. I do also show osteoperosis in the lumbar spine and femurs.
Calcium was normal with 9.4
Creatinine was 0.8
The MRI did show bone lesions but doesn't say from what. I assumed it was from the multiple myeloma. I do also show osteoperosis in the lumbar spine and femurs.
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Obayan
Re: Don't understand my lab results at all - help?
That's good news about your other markers. However, the presence of lytic lesions by themselves classify you as symptomatic unless they are explained by something other than myeloma. Again, you should discuss with your doctor and ask him why he thinks you are smoldering given the presence of lesions.
It's also a bit odd that you are in trial for high risk smoldering patients if you indeed have myeloma-related bone lesions. One of the key purposes of the high risk smoldering treatment trials is to determine if early treatment of smoldering patients can help stay off progression to symptomatic meyloma.
It's also a bit odd that you are in trial for high risk smoldering patients if you indeed have myeloma-related bone lesions. One of the key purposes of the high risk smoldering treatment trials is to determine if early treatment of smoldering patients can help stay off progression to symptomatic meyloma.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Don't understand my lab results at all - help?
Hi there,
I agree with Dr. Valent about discussing your situation directly with your doctor, especially since you shared your co-morbid conditions in your Introduction posting. I would imagine based upon the level of diagnostic testing you have had coupled with your participation in a clinical trial that you are being monitored by an multiple myeloma specialist. Have you sought out his/her expert advice on why he/she has specifically classified you as smoldering? As others have stated, it appears you have bone involvement (osteoporosis can be due to the multiple myeloma as well, not just lytic lesions) which would fulfill the B in the CRAB criteria for symptomatic disease. It would behoove you to understand exactly where you fit within the spectrum so you can determine if you are receiving the proper level of care at this time. Good luck to you.
I agree with Dr. Valent about discussing your situation directly with your doctor, especially since you shared your co-morbid conditions in your Introduction posting. I would imagine based upon the level of diagnostic testing you have had coupled with your participation in a clinical trial that you are being monitored by an multiple myeloma specialist. Have you sought out his/her expert advice on why he/she has specifically classified you as smoldering? As others have stated, it appears you have bone involvement (osteoporosis can be due to the multiple myeloma as well, not just lytic lesions) which would fulfill the B in the CRAB criteria for symptomatic disease. It would behoove you to understand exactly where you fit within the spectrum so you can determine if you are receiving the proper level of care at this time. Good luck to you.
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Anonymous 1
Re: Don't understand my lab results at all - help?
My doc is a multiple myeloma specialist. He says the lesions are only 9mm and are probably from a previous car accident I had years ago. The osteoperosis could be due to age and the fact that I'm over 20 years post menopausal. He said when you look at all the results together it does indicate a high risk smoldering stage and he gave me 8-10 months before it was full blown multiple myeloma. that was 3 months ago. The doctors running the study did their own complete set of testing as well and concur with the specialist I see. I don't know. Kind of a moot point now anyway. I can no longer afford travel to the treatment center. Before anyone even says it, I've already appealed to the IMF, ACS and LLS and Chronic disease Fund. They can't help me. Not for a trial study. And the trial itself won't help. So, I'm pretty much screwed.
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Obayan
Re: Don't understand my lab results at all - help?
Perhaps you need to seek another in-person opinion to help you sort out some of these inconsistencies so you can be confident in your treatment options. If the study is not the right fit, perhaps an actual treatment protocol for newly diagnosed multiple myeloma patients should be a consideration. There are always options, it just might take some time to sort it all out, but there are answers out there for you. If you are not comfortable where you are, take the next step. If both of your current specialist concur and are suggesting to you that your disease is aggressive with the 8-10 month progression time frame provided, it might make sense to get another opinion with a top multiple myeloma specialist soon.
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Anonymous 1
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