Hi there,
My dad was diagnosed with multiple myeloma. What areas of his blood work indicate whether the treatment he is receiving is effective?
Thank you so much.
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Re: How to know if treatment is being effective?
Hi Mandy_Pandy1,
On the full blood test report there are many individual tests, most of them are routine but important for individuals with specific problems, for example anemia showing in the red blood cell count, high calcium levels, kidney function, liver function, etc.
However the electrophoresis test is the analysis which is the myeloma indicator, If the test is showing only polyclonal variations, it is not of great concern, but the monoclonal augmentation is what we watch for, It usually shows in the gamma or beta region, which is to the far right. This monoclonal peak may rise with each test, indicating increased myeloma activity, It may be stable, and with treatment it will hopefully fall.
The actual number, usually as a percentage and in grams per litre or decilitre, is perhaps less important than the change from month to month, for this is what shows the effectiveness of the treatment. No change or a further rise shows the treatment is of limited or of no value, a fall shows a successful treatment to whatever degree.
Number relevance? The ideal is zero, Single digits are considered low and numbers above thirty require treatment, heading above fifty is increasingly urgent, for this is how many cancer cells are proliferating. Of course, monitoring will be carried out by your specialist who will decide the course of action required.
From a non-professional patient. Best Wishes, Victor L
On the full blood test report there are many individual tests, most of them are routine but important for individuals with specific problems, for example anemia showing in the red blood cell count, high calcium levels, kidney function, liver function, etc.
However the electrophoresis test is the analysis which is the myeloma indicator, If the test is showing only polyclonal variations, it is not of great concern, but the monoclonal augmentation is what we watch for, It usually shows in the gamma or beta region, which is to the far right. This monoclonal peak may rise with each test, indicating increased myeloma activity, It may be stable, and with treatment it will hopefully fall.
The actual number, usually as a percentage and in grams per litre or decilitre, is perhaps less important than the change from month to month, for this is what shows the effectiveness of the treatment. No change or a further rise shows the treatment is of limited or of no value, a fall shows a successful treatment to whatever degree.
Number relevance? The ideal is zero, Single digits are considered low and numbers above thirty require treatment, heading above fifty is increasingly urgent, for this is how many cancer cells are proliferating. Of course, monitoring will be carried out by your specialist who will decide the course of action required.
From a non-professional patient. Best Wishes, Victor L
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Victor L - Name: Victor L
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2012
- Age at diagnosis: 58
Re: How to know if treatment is being effective?
Hi Mandy Pandy,
Victor provided some good info.
To see if the myeloma cancer burden is going down, you want to primarily be looking at these two things:
1. M-spike (aka M-protein, m-protein, paraprotein, abnormal protein) value from the serum protein electrophoresis test.
2. Serum kappa and lambda free light chain (FLCs) values from the serum free light chain assay test.
Generally, if you see improvement in the above numbers, then any other issues such as anemia, renal (kidney) impairment or hypercalcemia will tend to improve as the cancer burden is lowered. If he was suffering from any of the aforementioned maladies, then you would want to also track his hemoglobin, creatinine and calcium levels, respectively
Lastly, to understand how he is responding, you really need to go back and see how these figures have changed since before treatment and now. So, you will want to plot their progress over time.
If you do post any values on this forum, please include the units of measure and any reference ranges. And if you do post any of the free light chain numbers, please post all of them (kappa, lambda and the ratio).
Good luck and let us know how things go.
Victor provided some good info.
To see if the myeloma cancer burden is going down, you want to primarily be looking at these two things:
1. M-spike (aka M-protein, m-protein, paraprotein, abnormal protein) value from the serum protein electrophoresis test.
2. Serum kappa and lambda free light chain (FLCs) values from the serum free light chain assay test.
Generally, if you see improvement in the above numbers, then any other issues such as anemia, renal (kidney) impairment or hypercalcemia will tend to improve as the cancer burden is lowered. If he was suffering from any of the aforementioned maladies, then you would want to also track his hemoglobin, creatinine and calcium levels, respectively
Lastly, to understand how he is responding, you really need to go back and see how these figures have changed since before treatment and now. So, you will want to plot their progress over time.
If you do post any values on this forum, please include the units of measure and any reference ranges. And if you do post any of the free light chain numbers, please post all of them (kappa, lambda and the ratio).
Good luck and let us know how things go.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How to know if treatment is being effective?
Hi Mandy,
I’ve just started a cyclophosphamide, Velcade (bortezomib), and dexamethasone (CyBorD) treatment for my multiple myeloma and, like you, I wondered how I would know if my treatment is going well. I asked my hematologist and she told me that the level of my M-proteins would be measured every 5 weeks. She was confident that this would give us the information we needed.
It takes some time before a decrease in M-protein is noticed. This is partly due to the fact that the existing M-proteins just don’t disappear upon start of treatment. They have a natural lifespan. The point of the chemotherapy is to kill off the cancerous plasma cells so that additional M-proteins do not form.
I will also have a CBC and differential blood test performed each week. This will monitor any falloffs in my immune system as well as platelet and red blood cell issues that might arise. Any loss of red blood cells are a particular issue for me as I was already fighting anemia before my diagnosis of myeloma.
Wishing your Dad good luck,
Joe
I’ve just started a cyclophosphamide, Velcade (bortezomib), and dexamethasone (CyBorD) treatment for my multiple myeloma and, like you, I wondered how I would know if my treatment is going well. I asked my hematologist and she told me that the level of my M-proteins would be measured every 5 weeks. She was confident that this would give us the information we needed.
It takes some time before a decrease in M-protein is noticed. This is partly due to the fact that the existing M-proteins just don’t disappear upon start of treatment. They have a natural lifespan. The point of the chemotherapy is to kill off the cancerous plasma cells so that additional M-proteins do not form.
I will also have a CBC and differential blood test performed each week. This will monitor any falloffs in my immune system as well as platelet and red blood cell issues that might arise. Any loss of red blood cells are a particular issue for me as I was already fighting anemia before my diagnosis of myeloma.
Wishing your Dad good luck,
Joe
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Wobbles - Name: Joe
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: June 2016
- Age at diagnosis: 67
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