Good morning,
I tried to copy and send the lab report, but it doesn't go through properly.
I am deciphering numbers as best I can. It must be hard to be patient with someone new who is clueless.
Free Kappa - 189.8
Free Lambda - 17.6
Free K/L - 10.78 (assuming this is ratio)
Free K/L appears to be going up minimally but still going up. Can this fluctuate?
Report said unchanged and no specific abnormalities.
Not sure what this is however these numbers were also high.
Monos -11.6
Eos - 7.6
Baso - 1.2 (actually went down from previous)
IgG - 831
IgA - 454
igM - 60
Monoclonal IgA kappa is still present in beta region.
All other blood work has not changed and is within normal limits.
I am hoping I gave you enough information.
Thanks
Forums
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PJD143 - Name: PJD143
- Who do you know with myeloma?: learning more as I go along
- When were you/they diagnosed?: My husband was diagnosed in August 2016
- Age at diagnosis: 57
Re: High-risk MGUS, low-risk smoldering - cause for worry?
When you look at lab numbers, they will almost always include the units of measure (e.g. mg/dL) and a reference range for the various numbers. Please always include that additional information when you post on the forum. As an example, your IgA number should be reported with a format that contains all of the following values (your reference range will probably be a bit different than my reference range below):
IgA: 414 mg/dL (ref 90-386 mg/dL)
10 is not a very large k/l ratio, which is good. All of your myeloma markers can fluctuate quite a bit and this is normal. To get an idea of how much my numbers fluctuate from test to test, see:
https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-60.html#p46149
Keep in mind that I'm not a doctor. But given you barely have a serum M-spike and/or have registered no serum M-spike and you have 10%-20% bone marrow plasma cells (assuming these are all monoclonal cells – check with your oncologist) and you are producing monocolonal free light chains, it almost seems like you might have "light chain smoldering myeloma". This is where your system is only producing monoclonal light chains (in your case, monoclonal kappa free light chains) that escape into your blood with very little or no accompanying monoclonal heavy chains (aka the serum "M-spike"). Light chain myeloma is not that uncommon and happens to about 20% of myeloma patients. It doesn't have any worse of a prognosis than non-light-chain myeloma. Again, I'm not a doctor, and this is something you might want to discuss with your oncologist.
IgA: 414 mg/dL (ref 90-386 mg/dL)
10 is not a very large k/l ratio, which is good. All of your myeloma markers can fluctuate quite a bit and this is normal. To get an idea of how much my numbers fluctuate from test to test, see:
https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-60.html#p46149
Keep in mind that I'm not a doctor. But given you barely have a serum M-spike and/or have registered no serum M-spike and you have 10%-20% bone marrow plasma cells (assuming these are all monoclonal cells – check with your oncologist) and you are producing monocolonal free light chains, it almost seems like you might have "light chain smoldering myeloma". This is where your system is only producing monoclonal light chains (in your case, monoclonal kappa free light chains) that escape into your blood with very little or no accompanying monoclonal heavy chains (aka the serum "M-spike"). Light chain myeloma is not that uncommon and happens to about 20% of myeloma patients. It doesn't have any worse of a prognosis than non-light-chain myeloma. Again, I'm not a doctor, and this is something you might want to discuss with your oncologist.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High-risk MGUS, low-risk smoldering - cause for worry?
Thank you for taking the time to explain what needed to be done.
Free Kappa - 189.9 (3.3 -19.4 mgL)
Free Lambda - 17.6 (5.7-26.3 mgL)
Free Kappa/Lambda - 10.78 (0.26-1.65)
IgG 831 (700-1600 mg/dl)
IgA 454 (70-400 mg/dL)
IgM 60 (40-230 mg/dl)
PEP: No specific abnormalities seen on SPEP. Based on IFE (see separate report), monoclonal IgA kappa is detected in beta-2 region. Cannot quantify by densitometry. Dontinue following serum total IgA levels to monitor SPEP.
Is this the protein measuring for spike?
Do you need any more information from the report? It must be frustrating feeling like you have to tutor a new person in this field. It appears like everyone else know so much more.
Your patience is appreciated.
Thanks
Free Kappa - 189.9 (3.3 -19.4 mgL)
Free Lambda - 17.6 (5.7-26.3 mgL)
Free Kappa/Lambda - 10.78 (0.26-1.65)
IgG 831 (700-1600 mg/dl)
IgA 454 (70-400 mg/dL)
IgM 60 (40-230 mg/dl)
PEP: No specific abnormalities seen on SPEP. Based on IFE (see separate report), monoclonal IgA kappa is detected in beta-2 region. Cannot quantify by densitometry. Dontinue following serum total IgA levels to monitor SPEP.
Is this the protein measuring for spike?
Do you need any more information from the report? It must be frustrating feeling like you have to tutor a new person in this field. It appears like everyone else know so much more.
Your patience is appreciated.
Thanks
-
PJD143 - Name: PJD143
- Who do you know with myeloma?: learning more as I go along
- When were you/they diagnosed?: My husband was diagnosed in August 2016
- Age at diagnosis: 57
Re: High-risk MGUS, low-risk smoldering - cause for worry?
Hello again,
I am hoping to get an appointment with a multiple myeloma specialist. Maybe they will explain this whole disease, blood work, etc. It seems like the doctor has not given us the information that we need to be able to understand this whole disease and to be part of this forum.
I am trying to read as much as possible online, but it's foreign when you don't even understand numbers, blood work abbreviations, etc.
I am sorry to have bothered you with so many questions.
Wishing you luck.
PJD
I am hoping to get an appointment with a multiple myeloma specialist. Maybe they will explain this whole disease, blood work, etc. It seems like the doctor has not given us the information that we need to be able to understand this whole disease and to be part of this forum.
I am trying to read as much as possible online, but it's foreign when you don't even understand numbers, blood work abbreviations, etc.
I am sorry to have bothered you with so many questions.
Wishing you luck.
PJD
-
PJD143 - Name: PJD143
- Who do you know with myeloma?: learning more as I go along
- When were you/they diagnosed?: My husband was diagnosed in August 2016
- Age at diagnosis: 57
Re: High-risk MGUS, low-risk smoldering - cause for worry?
I have become more educated with MGUS / smoldering multiple myeloma. However, when I read some of the reports, it's difficult to understand the way they are presented and the wording.
With that in mind, I am not sure what this means. On a report that I received it says "Plasma cells represent 5-10% of overall cellularity. Core showing plasma cells occupying 10-15% of overall cellularity." Cytogenetics positive for monosomy 13 (which I understand) . However rearrangement of IGH and positive for IGH/FGR3 is unclear. I am assuming this puts my husband in another category more towards a smoldering.
First they said it was MGUS and now they say it could be smoldering. (confusing)
Also, what are the criteria for low-risk smoldering? Maybe they don't use categories anymore?
We have an appointment with the specialist on Friday. I'm just trying to get questions together and gain a better understanding prior to the appointment.
With that in mind, I am not sure what this means. On a report that I received it says "Plasma cells represent 5-10% of overall cellularity. Core showing plasma cells occupying 10-15% of overall cellularity." Cytogenetics positive for monosomy 13 (which I understand) . However rearrangement of IGH and positive for IGH/FGR3 is unclear. I am assuming this puts my husband in another category more towards a smoldering.
First they said it was MGUS and now they say it could be smoldering. (confusing)
Also, what are the criteria for low-risk smoldering? Maybe they don't use categories anymore?
We have an appointment with the specialist on Friday. I'm just trying to get questions together and gain a better understanding prior to the appointment.
-
PJD143 - Name: PJD143
- Who do you know with myeloma?: learning more as I go along
- When were you/they diagnosed?: My husband was diagnosed in August 2016
- Age at diagnosis: 57
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