[elizabeth104]

General Question re: CRAB criteria

by elizabeth104 on Sun Jun 09, 2013 9:15 am

From what I understand, in order to be classified as symptomatic myeloma you have to meet at least one of the CRAB (CRAB-I) criteria.

My question is:

Would someone with bone involvement (the B in CRAB) always have elevated calcium (the C in CRAB)? In the same respect, would someone with elevated calcium (the C) always have bone involvement (the B)? If so… why are they separate letters in CRAB if they go together? Or, is there sometimes bone involvement without elevated calcium levels? Is there sometimes elevated calcium levels without bone involvement?

Thanks to anyone who can shed some light on this for me.

Last edited by elizabeth104 on Sun Jun 09, 2013 7:10 pm, edited 1 time in total.

[Nancy Shamanna]

Re: General Question re: CRAB criteria

by Nancy Shamanna on Sun Jun 09, 2013 7:00 pm

Hi Elizabeth..you don't necessarily have elevated levels of calcium in your blood if you have 'bone involvement' (read lytic lesions, fractures). I did not! As for the reverse, I don't know if elevated calcium in the blood is always associated with detectable bone damage, but you would think it probably was. From my understanding, the extra calcium is from the dissolving of bone. Maybe the checking of both symptoms is precautionary, in order to get a diagnosis in a timely fashion!

[elizabeth104]

Re: General Question re: CRAB criteria

by elizabeth104 on Mon Jun 10, 2013 7:12 am

Hi Nancy,

Thanks for the reply and sharing your experience. That's interesting you had the B but not the C. I guess I just assumed they would always coincide. Best wishes to you!

Elizabeth

[Nancy Shamanna]

Re: General Question re: CRAB criteria

by Nancy Shamanna on Mon Jun 10, 2013 11:49 am

Yes Elizabeth, I had a lot of bone damage actually and at the time didn't understand much about myeloma. Later, when I studied it more, I realized that I was fortunate not to have excess calcium in my bloodstream. Best wishes to you also!

[LibbyC]

Re: General Question re: CRAB criteria

by LibbyC on Mon Jun 10, 2013 8:04 pm

Hi Elizabeth,

I had the C, the A and B at dx, cant really remember if I had the R or not (it was a bit of a blur at the time). One of the first things they gave me in hospital was something to lower the calcium in my blood. If the bone lesions of a patient were not that extensive (or only a few) then the calcium may not be elevated. If someone has elevated calcium but no bone lesions it may be indicative of another malignancy/disease. As there are associated problems with too much calcium in the blood this level would need to be determined and appropriate treatment taken.

Libby

[elizabeth104]

Re: General Question re: CRAB criteria

by elizabeth104 on Mon Jun 10, 2013 10:04 pm

Thanks for the reply and sharing your experience, Libby! What you wrote about is exactly what I was hoping to clarify... if the B and C in CRAB would ever not be together. It sounds like the C probably wouldn't ever be without the B, but the B might be without the C, like in Nancy's experience.... I appreciate your response!

Take care,
Elizabeth

[Dr. Jason Valent]

Re: General Question re: CRAB criteria

by Dr. Jason Valent on Tue Jun 11, 2013 8:38 am

Agree with previous posts. You can have bone lesions without hypercalcemia. The hypercalcemia is often a late effect of extensive bone disease although can be seen at diagnosis as well.

[morrow1022]

Re: General Question re: CRAB criteria

by morrow1022 on Tue Jun 11, 2013 10:31 am

Hi,

Was dx a year 15 months ago. Out of the CRAB only had B. The back pain is what finally sent me to my GP who did blood work and noticed a rise in my Mspikes. Off to oncologist who dx me after alot of scans and marrow biospy. So yes you can have B without C.

Kudos to my GP for picking it up so soon and to my wonderful oncologist.

[elizabeth104]

Re: General Question re: CRAB criteria

by elizabeth104 on Thu Jun 13, 2013 5:10 pm

Thank you to Dr. Valent and everyone else who responded to my question!