Thanks for your answer, Dr. Valent. When Jet asked this question, I was wondering if two transfusions would be enough to raise her ferritin to the extent that she mentioned.
Sandy and Jet - From what I have heard and read, there is quite a bit of research showing that blood cancers like myeloma can raise ferritin levels. There also have been several studies involving myeloma patients that have showed that ferritin levels at specific points in time – like, at diagnosis, or after a stem cell transplant – are correlated with a patient's prognosis. So this sort of evidence suggests that ferritin levels can track, to some degree, changes in a patient's disease.
The problem, however, is that there are a lot of things that can cause someone's ferritin to be elevated. A good article I found on the subject explains that:
Raised serum ferritin can be caused by five main mechanisms: damage to ferritin-containing tissues, for example, the bone marrow and liver; inflammation or infection, because ferritin is an acute-phase protein; genetic iron-loading conditions; secondary iron-loading conditions, which are mainly due to blood transfusions but are also seen in African haemosiderosis due to the ingestion of large quantities of iron; and chronic anaemias caused by ineffective haematopoesis, for example, thalassaemias.
Source: "High serum ferritin," GP, Aug 31, 2007 (link to article)One of the reasons in that list, which is relevant to Jet's situation, is blood transfusions. But the first two reasons, which include damage to the bone marrow and inflammation or infection, are things that can be directly and indirectly caused by multiple myeloma.
But inflammation and infections also can be caused by other things unrelated to how active a myeloma patient's disease is. Even simple things like how much alcohol you drink and your weight can have an impact on ferritin levels.
So, while ferritin levels can give some sense of whether a patient's myeloma is becoming more, or less, active, it's not a direct signal – like a patient's M-spike or free light chain levels – and it's also a noisy signal.
So doctors may watch ferritin levels in myeloma patients just to give them as complete a picture as possible about what's going on with their disease. But other measures, like the M-spike and FLC levels that I just mentioned, are more reliable reflections of a patient's disease state in most cases.
Sorry this went on for a bit. I hope it's helpful!
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