Although secretory, my numbers were never high, making my multiple myeloma more difficult to track. My myeloma was discovered via a plasmacytoma which broke out of my tibia, and subsequent imaging showed lesions in my limbs. I'm in my last cycle of Revlimid, Velcade, dexamethasone (RVd), and I discussed stem cell transplantation (preference for harvest and store, rather than transplant) with the transplant team this last week.
I'm IgA lambda, and my numbers came into normal range during the first cycle, and except for my surgical leg, limb bone pain disappeared early in Cycle 3.
A few weeks ago, I complained about return of bone discomfort. Thursday's blood work shows IgA increased in 3.5 weeks from 274 to 340 (ref range 69-309). It was 386 at beginning of induction.
I realize this is a small number, but am viewing it in conjunction with my numbers never showing high, change in bone pain, and new kidney information.
Light chain numbers (also never high) won't be posted until Monday / Tuesday.
Perhaps most worrying is that for the first time ever my kidney function, which has been solidly normal, took a dive. Change in last 3.5 weeks:
Creatinine 0.63 to 1.38 (ref 0.4 - 1.0)
eGFR 94 to 40 (ref >60)
BUN 18 to 31 (ref 5 - 25)
Will see my local oncologist mid-week, but am extremely concerned. I know chemo helps kidneys as the myeloma is tamed, but what about decreasing function during induction? And so quickly? What could be causing this? I've had no medication changes.
I have no cytogenetic information as my initial bone marrow biopsy came back <5% plasma cells.
Thanks for any input.
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Re: IgA, creatinine & BUN increasing at end of induction
Hi moonscape.
You were diagnosed at about the same time as my husband. We might have even walked by each other in the Blake Wilbur building at Stanford. i suspect we were seen by the same specialist who we also found excellent. We elected to get treatment here in San Francisco but primarily because of geography and convenience. (I am not without bias, however, as I trained at Stanford and still have an affiliation).
Your renal tests likely require your myeloma specialist's input again and some additional urine testing and perhaps a nephrologist's input. This may be the myeloma but there are certainly other explanations. The Revlimid can effect renal function as can your prophylactic antibiotic (Septra, sulfamethoxazole and trimethoprim) which can both affect the kidneys and falsely affect lab testing. And your changed renal function might affect your IgA level as well (if you are not clearing protein that you were) and cause fatigue / cramping / pain. There may be other unrelated explanations.
You've got a smart team at Stanford. Ii hope you can relax while they sort this all out.
Wishing you well.
You were diagnosed at about the same time as my husband. We might have even walked by each other in the Blake Wilbur building at Stanford. i suspect we were seen by the same specialist who we also found excellent. We elected to get treatment here in San Francisco but primarily because of geography and convenience. (I am not without bias, however, as I trained at Stanford and still have an affiliation).
Your renal tests likely require your myeloma specialist's input again and some additional urine testing and perhaps a nephrologist's input. This may be the myeloma but there are certainly other explanations. The Revlimid can effect renal function as can your prophylactic antibiotic (Septra, sulfamethoxazole and trimethoprim) which can both affect the kidneys and falsely affect lab testing. And your changed renal function might affect your IgA level as well (if you are not clearing protein that you were) and cause fatigue / cramping / pain. There may be other unrelated explanations.
You've got a smart team at Stanford. Ii hope you can relax while they sort this all out.
Wishing you well.
-
rick - Name: rick
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: nov 2015
- Age at diagnosis: 50
Re: IgA, creatinine & BUN increasing at end of induction
Moonscape,
I can't speak for the increase in IgA, but my BUN and creatinine and GFR were out of range after induction. Creatinine1.22, GfR 46, and BUN 31. It turned out it was the weekend antibiotic (preventative) that I was on. The antibiotic was Bactrim (sulfamethoxazole and trimethoprim). My oncologist took me off to see if it would help and those numbers went back into the normal range.
I can't speak for the increase in IgA, but my BUN and creatinine and GFR were out of range after induction. Creatinine1.22, GfR 46, and BUN 31. It turned out it was the weekend antibiotic (preventative) that I was on. The antibiotic was Bactrim (sulfamethoxazole and trimethoprim). My oncologist took me off to see if it would help and those numbers went back into the normal range.
-
Janet1520
Re: IgA, creatinine & BUN increasing at end of induction
Thank you both very much for your response. It meant a lot last weekend when I was enormously stressed at the results.
We redid my metabolic panel during the week, and my numbers (except the smallest BUN tick) were back in range. No idea the reason, but assume that is what was affecting my IgA, as you said Rick. Had no medication changes, was hydrated at time of test - just don't know.
The wisest thing anyone said to me was a friend who, from the beginning, cautioned during this cancer ride not to get too excited by great numbers, nor too depressed by bad ones. He's right, but being a newbie, I still need to settle into that balanced groove.
Your husband is so fortunate, Rick, to have your medical knowledge (and you of course!) at his side. Being without basic, fundamental medical knowledge makes the learning curve so very steep for someone like me, and feedback extremely valuable.
We're fortunate to have the choice of two such excellent cancer centers geographically accessible.
We redid my metabolic panel during the week, and my numbers (except the smallest BUN tick) were back in range. No idea the reason, but assume that is what was affecting my IgA, as you said Rick. Had no medication changes, was hydrated at time of test - just don't know.
The wisest thing anyone said to me was a friend who, from the beginning, cautioned during this cancer ride not to get too excited by great numbers, nor too depressed by bad ones. He's right, but being a newbie, I still need to settle into that balanced groove.
Your husband is so fortunate, Rick, to have your medical knowledge (and you of course!) at his side. Being without basic, fundamental medical knowledge makes the learning curve so very steep for someone like me, and feedback extremely valuable.
We're fortunate to have the choice of two such excellent cancer centers geographically accessible.
-
moonscape - Who do you know with myeloma?: me
- When were you/they diagnosed?: 11/2015
4 posts
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