[KBinNC]

Jump in labs (I think) - what's it mean?

by KBinNC on Mon Jun 20, 2016 6:34 pm

I had my labs drawn this morning and *some* results have already popped in to my portal. Usually it takes a few days.

I don't have my M-spike and others yet, but what I have seen is scaring me

Does anyone have any arm chair wisdom on almost everything going up besides Total Protein being normal?

TIA I don't see my onc for another 12 days as the labs usually take that long to report in.

Test 2015 2016
Nov 25 Jan 13 Mar 23 Apr 20 Jun 20
K/L FLC Ratio 0.26-1.65 8.50 7.24 7.82 7.90 8.56
Kappa Free, Serum 0.33-1.94 7.29 6.23 6.49 5.77 7.70
Lambda Free, Serum 0.57-2.63 0.86 0.86 0.83 0.73 0.90

IgA 40.0-400.0 199 253 229 225.7 240.2
Total IgG 600-1700 1840 2557 2489 2389 2421
IgM 35-290 31 36 30 32 38
Total Protein 6.6-8.0 7.4 8.3 8.5 8.5 8.0

M-spike 1.6 2.3 2.5 2.4 TBD

[TerryH]

Re: Jump in labs (I think) - what's it mean?

by TerryH on Mon Jun 20, 2016 6:57 pm

KB,

I would not get too worked up by these results. You really need to see clear trends, which you can see best with graphs, but even just looking at your results, you only see trends in the wrong direction if you leave out certain data points.

Your latest FLC ratio is almost exactly what it was last November. Yes, it's gone up since the past couple of times, but it's just barely higher than it was last November. Same for your kappa FLC level.

Your IgG level is lower than it was in January, and more importantly, your IgA and IgM levels are about as high as they've been. So you haven't experienced additional suppression in the production of your uninvolved immunoglobulins.

I wouldn't be surprised if your M-spike is essentially unchanged, or perhaps even slightly lower, compared to the last time.

If you haven't already, you should see the plots Multibilly has made of his lab results, which you can find in the Tricor thread here in the forum. Here are the latest plots:

https://myelomabeacon.org/forum/post41916.html#p41916

Good luck!

[FingersCrossed]

Re: Jump in labs (I think) - what's it mean?

by FingersCrossed on Tue Jun 21, 2016 11:10 am

I don't see anything that worrisome, to be honest. But that's just my non-medical opinion, of course.

The kappa level doesn't look that different from the November level. Nor is the lambda level that much different than November. The IgG looks like normal fluctuation.

I'd be curious to see what your M-spike is, but I'll bet it's still 2-point-something.

My FLC ratio jumped up one month and I freaked out about it. It was back down the next time I had labs done.

Set up a spreadsheet and input all of your lab results from the past year. I did that and whenever I get nervous about a number going up, I'll go back and look at my history and see that I've been at that level before. Then, when I actually graph a certain series (e.g., just platelets, or just M-spike, or just IgG), there's not much of an upward trend discernible at all.

[KBinNC]

Re: Jump in labs (I think) - what's it mean?

by KBinNC on Wed Jun 22, 2016 5:56 pm

I just received my M-spike; it is 2.4 g/dL (24 g/l).

All in all, I am feeling "pretty stable" when I look at my numbers over the past 6 months. Since my bone marrow biopsy showed a plasma cell percentage above 10%, I wonder if I should request to have it repeated since it would be 7 months by the time it was scheduled, to see what my percentage is there. I am shuddering with the thought of proposing the thought of undergoing another bone marrow biopsy, but maybe my labs tell enough of the story that I don't need another biopsy just yet. Man, I can't wait until the day I no longer feel so ignorant about all of this.

Anyone have thoughts on the frequency of the bone marrow biopsy?

[TerryH]

Re: Jump in labs (I think) - what's it mean?

by TerryH on Thu Jun 23, 2016 10:16 am

KB,

Glad to hear the M-spike came in as expected.

I am not sure why you should feel that more regularly bone marrow biopsies will be necessary. First of all, bone marrow biopsies are not perfect. Multiple myeloma is often "patchy", so you'll hit some myeloma cells in one area of bone marrow, but maybe not in another.

Also, there isn't really any sign that your blood testing is failing in terms of giving you a sense of what is happening with your disease. I get it that the labs are bouncing around some, but that doesn't mean they aren't giving a reasonable picture of where your disease is and where it's heading.

Honestly, if you just plot the results – using a spreadsheet program or even just by hand – it will help you feel more comfortable with what changes are important, and what changes are not.

Good luck!

[KBinNC]

Re: Jump in labs (I think) - what's it mean?

by KBinNC on Sun Aug 21, 2016 11:38 am

My recent labs for beta-2 globulin and gamma globulin seem to have flip-flopped. Is that of concern? My WBC is also dropped and FLC % continues to climb.

The labs below are all 2 months apart, with the last numbers being last week (I'm not sure how formatting will work with the cut/paste) I have been having a lot of symptoms escalate lately and my myeloma specialist doesn't think it's related to multiple myeloma, but when I saw these two labs, I thought I would ask my fellow forum members.

Other labs appear to be "stable" since diagnosis in November, 2015 but I noticed these changes as well:

WBC was 9.9 on June 20 and is now 4.7.

Test Apr 20 Jun 20 Aug 17

Beta-2 globulin 2.7 2.6 0.6
Gamma globulin 0.4 0.3 2.4
KL FLC % 7.90 8.56 9.43

I think these are stable:

Test Apr 20 Jun 20 Aug 17

IgA 227.1 240.2 218.7
IgG 2389 2421 2276
IgM 32 38 36
Total Protein 8.0 7.9 8.5

I do not have my M-spike back yet on my patient portal.

[FingersCrossed]

Re: Jump in labs (I think) - what's it mean?

by FingersCrossed on Sat Aug 27, 2016 4:28 pm

Have you received your M-spike number? I think that will be instructive about what's going on here.

It almost seems like the numbers got reversed.

As for your WBC, that can fluctuate just like other numbers. I wish I had a WBC number like 4.7. I'm lucky if I get as high as 3.0. I'm usually around 2.5.

[Multibilly]

Re: Jump in labs (I think) - what's it mean?

by Multibilly on Sat Aug 27, 2016 7:36 pm

KBinNC,

I agree with the others that your numbers don't look worrisome and that graphing your results would make this pretty clear. I also don't think that most specialists would recommend another bone marrow biopsy unless there was a pretty dramatic change in one or more of your key lab numbers and/or you were starting to exhibit one or more of the CRAB criteria.

You might want to look at some of my historical numbers to see just how much numbers can routinely fluctuate. At first blush (but without the benefit of seeing your numbers in graph form), your numbers appear more stable than mine. But be clear that all the medical professionals on my side are quite happy with the way things are going for me.

https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-50.html#p41916

Regarding your latest numbers, it is peculiar that your beta2 and gamma globulin levels have changed fairly dramatically, yet your IgG/IgA/IgM all seem stable. I also agree with FC that it almost seems like your beta2 and gamma globulin levels reversed. Your M-spike level will provide another clue, but I might be inclined to say that there was a lab error on your SPEP and that you should re-run it.