[sagittarian]

Is my MGUS progressing?.

by sagittarian on Mon Dec 11, 2017 2:45 pm

Greetings,

I've been seeing a hematologist for about six years.

In 2011 I had these numbers:

SPEP M-spike = 0.5 g/dL (5 g/l)

UPEP - all normal readings
M-spike - none observed

Kappa LT - 8.85
Lambda Lt - 0.87
K/L ratio - 10.17

Immunofixation:

IgG 944 normal
IgA 40 low
IgM 34 low

In the intervening years, serum M-spike has been in the 0.6-0.75 g/dL range. It's currently 0.66 g/dL.

However my current UPEP numbers show much higher readings than in 2011.

Protein 24 hr urine = 216 (high)
M-spike % = 1.7 (high)
M-spike mg/24 hr = 3.7

Most recent SPEP readings

Kappa LC = 8.55
Lambda LC = 150.9
K/L ratio = 0.06

IgA 38
lgG 1094
IgM 50

I had a PET scan in May, which was totally clean

I don't have symptoms to speak of, I'm 66 with disc problems in neck and lower back which cause pain. Also suffered from Lyme disease and went through several rounds of antibiotics seven years ago.

Question is what to do now, I feel like I should consult an multiple myeloma specialist; my hematologist is not and she won't speculate as to likelihood of progression to multiple myeloma.

Would appreciate any and all feedback, as this is much on my mind and very worrying.

[Multibilly]

Re: Is my MGUS progressing?.

by Multibilly on Tue Dec 12, 2017 6:33 pm

Hi Sagittarian,

Are both of your light chain readings from a SERUM FREE light chain assay? I ask because your free light chain ratio has apparently flipped - which seems odd to me. Put another way, your lambda value went from being low to now being high.

If these light chain values were indeed taken from the same two types of serum free light chain tests, your lambda free light chain value has increased a fair amount. The increase in your lambda free light chain protein level might explain why your UPEP is now showing an M-spike that is likely made up of monoclonal lambda protein. Basically, some of your excess lambda free light chains in your blood are now making it through your kidneys and spilling over into your urine.

I always think its a good idea to touch base with a multiple myeloma specialist from time to time, especially if it will help put your mind at ease.

[sagittarian]

Re: Is my MGUS progressing?.

by sagittarian on Mon May 21, 2018 10:37 am

After being with the same hematologist for 6 years, I decided to consult a myeloma specialist at a university medical center. A myriad of tests followed, including a low dose whole body CT
scan, which was totally clean. I am asymptomatic.

Here are some other key results:

From February 2018:

SPE M-spike - 1.2 g/dL
Protein Electrophoresis Serum
Discreet band in the beta 2 region
IgG lamba monoclonal protein.

Kappa LC 13.6
Lambda LC 215
K/L ratio: 0.06
(L/K ratio: 15.81)

UPE Electrophoresis (24hr)
Protein: 252
Minimal Protein Staining
No monoclonal protein noted

From April 2018:

SPE M-spike. 1.0 g/dL

Kappa LC 8.78
Lambda LC 112
K/L Ratio 0.08
(L/K Ratio: 12.76)

UPE Electrophoresis (24hr)
Protein: 201
Minimal Protein Staining
No monoclonal protein noted

I have been taking curcumin since January, from 3-4 g daily.

Question in my mind: The near 50% drop in kappa and lambda numbers, what else could explain that?

Then I looked again at the kappa / lambda lab result and saw this disclaimer: "This immuno­assay test may yield falsely low results due to antigen excess. Results must be interpreted in light of other lab tests and clinical evidence."

As much as I'd like to think that curcumin played a role in this, there could be other explanations. Would appreciate a perspective on this!

And thanks for this wonderful resource!