[Lper]

Drop in free light chain ratio, but constant M-spike

by Lper on Fri Dec 02, 2016 7:38 am

I'm 42 and was diagnosed with multiple myeloma this past April.

The disease was caught early as I was being monitored twice a year due to MGUS which was discovered during an unrelated bout with pneumonia back in 2008. At diagnosis, I was just below the normal haemoglobin range level at 134 g/l, was found to have a 1 - 1 cm lesion in my left arm and 30% plasma levels. I didn't feel any of the typical symptoms and in fact was feeling better than I had in years due to getting back to exercising and taking on a new approach to diet.

My M-spike was quite low at diagnosis at 6 g/l (0.6 g/dl), but my free light chain ratio was around 6200. The ratio dropped to 2500 from induction therapy with cyclophosphamide, Velcade (bortezomib), and dexamethasone (CyBorD).

Thirty days following my autologous stem cell transplant (ASCT), the ratio went down further to 550, but my M-spike stayed at 2 g/l (0.2 g/dl), which was the level pre-transplant. In fact, the M-spike has been at 2 since the end of the second of four cycles of induction chemo.

I've tolerated all treatment well and was back to work less than 2 months after my transplant.

Should I be concerned that I achieved a very good partial response from my transplant based on my free light chain ratio, but no change to my M-spike?

[Mike F]

Re: Drop in free light chain ratio, but constant M-spike

by Mike F on Fri Dec 02, 2016 2:54 pm

Hi Lper -

I think it's pretty common for the M-spike number to take a while to drop down after a transplant. Mine stayed detectable for somewhere around a year afterwards (despite normal light chain numbers), before finally dropping to an undetectable level, where it's been for some time now. I believe others here have had similar experiences.

Best wishes on your continued recovery!

[Lper]

Re: Drop in free light chain ratio, but constant M-spike

by Lper on Sat Dec 03, 2016 8:07 am

Thanks, Mike.