Hello,
I am 76 years old living in Greece. After finding an anemia with Hgb 10.2 and HCT 33.8 with an ESR 103-118, a C reactive protein 40, proceeded to trace proteins:
Albumin 46.7
Alpha1 4.5
Alpha2 13.7
Beta 10.8
Gamma 24.3
Later:
IgG 2058
IgM 17
IgA 56
Kappa free chains 0.94
Lambda free chains 70.4
Ratio 0.01
Thank you in advance.
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• Page 1 of 1
Re: Initial tests
Hello jes9,
Let me start by saying that I'm not a doctor and, even if I were, I don't have all your test results in front of me. However, based on the results you've shared in your posting, it does look like you may have some sort of plasma cell disorder. Without further testing, though, it can't be determined yet what the disorder is, and whether or not it will require treatment.
Based on your hemoglobin level, you are anemic. You have an elevated IgG level, and your IgM and IgA levels are below normal. You don't say whether your free light chain results are from a blood or urine test, and you also don't mention the units. Regardless, it's almost certain that your lambda free light chain level is elevated, which is demonstrated by the very low kappa / lambda free light chain ratio.
All of these results suggest that you could have mutated plasma cells in your bone marrow which are producing too much IgG and lambda light chains, and which are also suppressing the production of your other immunoglobulins and your red blood cells (leading to your anemia).
The albumin, alpha1, alpha2, etc., results you list are almost certainly from a test known as the serum protein electrophoresis (SPEP) test. The test will also usually report the level of any monoclonal protein (also called "paraprotein", "M-protein", or "M-spike"), if one was detected. Is there anything in the report for that test mentioning such a result and, if so, what is the result? (Please include the units, which will probably be either g/L or g/dL.)
Also, did you have a test run known as a serum immunofixation (IFE)? It detects whether or not a monoclonal protein can be found in the blood. However, it does not measure it.
The other lab results that you should be looking at are ones related to your kidney function (for example, your creatinine level) and your bones (for example, the calcium level in your blood, or x-rays or other imaging that you may have had done).
The most important results to know right now, however, are whether there was any sign of a monoclonal protein on your SPEP, and the result of any IFE test you may have had done.
I am sorry that I don't have better news to share with you, but I hope the information I've provided is helpful. Best wishes,
Jonah
Let me start by saying that I'm not a doctor and, even if I were, I don't have all your test results in front of me. However, based on the results you've shared in your posting, it does look like you may have some sort of plasma cell disorder. Without further testing, though, it can't be determined yet what the disorder is, and whether or not it will require treatment.
Based on your hemoglobin level, you are anemic. You have an elevated IgG level, and your IgM and IgA levels are below normal. You don't say whether your free light chain results are from a blood or urine test, and you also don't mention the units. Regardless, it's almost certain that your lambda free light chain level is elevated, which is demonstrated by the very low kappa / lambda free light chain ratio.
All of these results suggest that you could have mutated plasma cells in your bone marrow which are producing too much IgG and lambda light chains, and which are also suppressing the production of your other immunoglobulins and your red blood cells (leading to your anemia).
The albumin, alpha1, alpha2, etc., results you list are almost certainly from a test known as the serum protein electrophoresis (SPEP) test. The test will also usually report the level of any monoclonal protein (also called "paraprotein", "M-protein", or "M-spike"), if one was detected. Is there anything in the report for that test mentioning such a result and, if so, what is the result? (Please include the units, which will probably be either g/L or g/dL.)
Also, did you have a test run known as a serum immunofixation (IFE)? It detects whether or not a monoclonal protein can be found in the blood. However, it does not measure it.
The other lab results that you should be looking at are ones related to your kidney function (for example, your creatinine level) and your bones (for example, the calcium level in your blood, or x-rays or other imaging that you may have had done).
The most important results to know right now, however, are whether there was any sign of a monoclonal protein on your SPEP, and the result of any IFE test you may have had done.
I am sorry that I don't have better news to share with you, but I hope the information I've provided is helpful. Best wishes,
Jonah
-
Jonah
Re: Initial tests
Dear Jonah,
Thank you for your time so much.
All x rays were clear. No bone lytic damage at all, although I have had for years arthritis after a major car accident.
Scheduling nie a bone sample.
What do people do for anemia meanwhile?
Be well
j
Thank you for your time so much.
All x rays were clear. No bone lytic damage at all, although I have had for years arthritis after a major car accident.
Scheduling nie a bone sample.
What do people do for anemia meanwhile?
Be well
j
Re: Initial tests
Welcome to the forum, jes9.
Anemia can be treated in a number of different ways, ranging from iron supplements to transfusions to drugs known as "erythropoiesis-stimulating agents" (ESAs, commonly known as "epo"). The Wikipedia article on anemia has a section on treatments that might be helpful:
http://en.wikipedia.org/wiki/Anemia#Treatments
Before starting drug treatment for the anemia, however, it's worth making sure the anemia is actually causing you problems, particularly fatigue. This tends to vary a lot from person to person. A hemoglobin level that in one person would cause tremendous fatigue may cause only limited, or no, fatigue in another person.
Jonah gave you some helpful feedback and advice. It sounds like you'll be getting a bone marrow biopsy soon, which is a sensible next step. Did your SPEP or IFE show any signs of a monoclonal protein?
Good luck!
P.S. - In case it's helpful, here is Google's translation of the Wikipedia article about anemia into Greek. The Greek Wikipedia article on anemia does not seem to have as much information as the English anemia article, so the Google translation of the English article may be more helpful.
Anemia can be treated in a number of different ways, ranging from iron supplements to transfusions to drugs known as "erythropoiesis-stimulating agents" (ESAs, commonly known as "epo"). The Wikipedia article on anemia has a section on treatments that might be helpful:
http://en.wikipedia.org/wiki/Anemia#Treatments
Before starting drug treatment for the anemia, however, it's worth making sure the anemia is actually causing you problems, particularly fatigue. This tends to vary a lot from person to person. A hemoglobin level that in one person would cause tremendous fatigue may cause only limited, or no, fatigue in another person.
Jonah gave you some helpful feedback and advice. It sounds like you'll be getting a bone marrow biopsy soon, which is a sensible next step. Did your SPEP or IFE show any signs of a monoclonal protein?
Good luck!
P.S. - In case it's helpful, here is Google's translation of the Wikipedia article about anemia into Greek. The Greek Wikipedia article on anemia does not seem to have as much information as the English anemia article, so the Google translation of the English article may be more helpful.
-
JimNY
Re: Initial tests
Jes9 -
An answer to your question about how to treat the anemia? First, you need to know what the cause of the anemia is. If it is due to an iron deficiency, then likely iron supplements will help. If it is due to an inability to use iron, then there are other treatments that your doctor would order. If it is due to multiple myeloma, or other blood cancer, or disorder, then treatment of that condition would be the answer.
Your Hgb is low, but not dangerously low. Here in the US, treatment for the myeloma usually leads to an improvement of the anemia as the number of cancerous cells in the bone marrow decrease. Sometimes injections of the epo drugs that JimNY mentions can be done to improve the Hgb level. I have received a Neupogen injection (a GCSF drug, i.e., growth factor) for low Hgb levels. The last one that I received when my Hgb had dropped to 9.3 acted within hours. I had been so fatigued that I could barely do anything. A few hours after the injection, I felt like a curtain had been lifted from my eyes and the fatigue was gone.
You should wait until all of the testing is done to determine what is going on with you. Then the treatment that is recommended will help the anemia. If nothing is found that requires immediate treatment, you can ask your doctor what can be done to help the anemia.
Nancy in Phila
An answer to your question about how to treat the anemia? First, you need to know what the cause of the anemia is. If it is due to an iron deficiency, then likely iron supplements will help. If it is due to an inability to use iron, then there are other treatments that your doctor would order. If it is due to multiple myeloma, or other blood cancer, or disorder, then treatment of that condition would be the answer.
Your Hgb is low, but not dangerously low. Here in the US, treatment for the myeloma usually leads to an improvement of the anemia as the number of cancerous cells in the bone marrow decrease. Sometimes injections of the epo drugs that JimNY mentions can be done to improve the Hgb level. I have received a Neupogen injection (a GCSF drug, i.e., growth factor) for low Hgb levels. The last one that I received when my Hgb had dropped to 9.3 acted within hours. I had been so fatigued that I could barely do anything. A few hours after the injection, I felt like a curtain had been lifted from my eyes and the fatigue was gone.
You should wait until all of the testing is done to determine what is going on with you. Then the treatment that is recommended will help the anemia. If nothing is found that requires immediate treatment, you can ask your doctor what can be done to help the anemia.
Nancy in Phila
-
NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
5 posts
• Page 1 of 1