Hi there,
I am new to this site and new to the roller coaster ride I am now on. Can't sleep with worry ...
I am 54 with the following:
Total protein 93 g/l high (64-85)
Albumin 38 g/l low end of normal (38-50)
Globulin 55 g/l high (22-39)
IgG 27.1 g/l high (5.2-16)
IgA 0.75 g/l low (0.85-3.5)
IgM 0.23 g/l low (0.32-3.0)
IgG kappa 26 g/l (I think this is the M spike)
Calcium - normal
Renal - normal
Anaemia - none
Bone scan - normal, including no evidence of lymphoma
FLC ratio - normal
Urine - normal
No symptoms at all; found on a routine blood test (yearly)
Bone marrow biopsy is tomorrow with FISH, etc, so another 2-3 weeks wait. He says that this is the key to determining the treatment routine. Doc says I am too young for MGUS and will be smoldering multiple myeloma or multiple myeloma. With such a high IgG, I am expecting a high plasma reading. Is that right?
Can anyone offer any comments or experience? I am located in Australia (Melbourne) if anyone can offer a specialist for a second opinion.
I am also starting to take curcumin - I do not want chemo if I have no symptoms BUT I need advice on this.
Many thanks.
Forums
6 posts
• Page 1 of 1
Re: What diagnosis do my lab results suggest?
Hi Maggiedog,
Welcome to the forum.
I'm not sure what your doc means by the statement "you are too young to have MGUS". Everyone that has smoldering multiple myeloma or symptomatic multiple myeloma started off with MGUS.
While an M-spike of 26 g/l (2.6 g/dL) is somewhat high, it won't necessarily translate into a bone marrow plasma percentage (BMPC) of >10% (the cutoff between MGUS and smoldering multiple myeloma). And it certainly doesn't mean that you would have a BMPC of > 60% (which is known as a "myeloma defining event" (MDE)). See this link for more on MDEs:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
But what jumps out at me is that all of your non-monoclonal immunoglobuin levels are suppressed. Your non-monoclonal (healthy) IgG = 27.1g/L - 26g/L= 1.1 g/L (110 mg/dL), which is quite a bit below the normal, healthy IgG level. Also, your IgA and IgM are suppressed.
You say your serum FLC ratio is "normal". What are your lambda and kappa FLC values?
You also said your urine test results were normal. Was the urine test based on a 24-hour collection and were all of the lab results from that test in fact normal?
Lastly, you say you have no symptoms. But have you been getting sick more often or having more infections recently? I ask this because your immune system seems to be compromised by virtue of your low non-monoclonal IgG, IgM and IgA levels, which are all key antibodies that help fight off infections.
Welcome to the forum.
I'm not sure what your doc means by the statement "you are too young to have MGUS". Everyone that has smoldering multiple myeloma or symptomatic multiple myeloma started off with MGUS.
While an M-spike of 26 g/l (2.6 g/dL) is somewhat high, it won't necessarily translate into a bone marrow plasma percentage (BMPC) of >10% (the cutoff between MGUS and smoldering multiple myeloma). And it certainly doesn't mean that you would have a BMPC of > 60% (which is known as a "myeloma defining event" (MDE)). See this link for more on MDEs:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
But what jumps out at me is that all of your non-monoclonal immunoglobuin levels are suppressed. Your non-monoclonal (healthy) IgG = 27.1g/L - 26g/L= 1.1 g/L (110 mg/dL), which is quite a bit below the normal, healthy IgG level. Also, your IgA and IgM are suppressed.
You say your serum FLC ratio is "normal". What are your lambda and kappa FLC values?
You also said your urine test results were normal. Was the urine test based on a 24-hour collection and were all of the lab results from that test in fact normal?
Lastly, you say you have no symptoms. But have you been getting sick more often or having more infections recently? I ask this because your immune system seems to be compromised by virtue of your low non-monoclonal IgG, IgM and IgA levels, which are all key antibodies that help fight off infections.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What diagnosis do my lab results suggest?
Hi Multibilly,
I appreciate your time in answering me.
I don't have all the information written down but ...
FLC were 6 and 7 but not sure which was which; this is just what I got from doc's notes.
I did not realise to subtract the 27.1 and 26. You make a good point here about overall down immune system. If 1.1 g/l is low, what is the normal range for this measure?
It was not a 24-hour test - doc has not wanted one, yet. I did not mention that an earlier urine test (not 24-hour) in November that kicked off this 'ride' showed <0.01 g/l of IgG kappa detected in urine with overall urine protein of 0.04 g/l (0.0-0.20). The subsequent test was zero but from a different lab. I will ask him when I see him this week.
LSM was also normal (no numbers given).
No sickness at all apart from one urinary tract Infection that cleared with antibiotics back around July 2015. No colds; had the flu shot in April.
However, I had a dose of salmonella this year that put me on IV antibiotics and hospitalised in May. I look back now and those blood results were not normal yet nothing was said by doctor and I didn't ask. I have queried if these events are related and current specialist says no as this would have been building for a while. Very old blood tests show some elevation in total protein occasionally, but borderline. Coincidence?
I do wonder if the salmonella has kicked this off but I am not a doctor. I now want to unkick it!
I have a had a stressful year with a family issue and in very demanding job for 6 months that interrupted my sleep and increased my anxiety. Again, too much of a coincidence?
Thankyou again.
I appreciate your time in answering me.
I don't have all the information written down but ...
FLC were 6 and 7 but not sure which was which; this is just what I got from doc's notes.
I did not realise to subtract the 27.1 and 26. You make a good point here about overall down immune system. If 1.1 g/l is low, what is the normal range for this measure?
It was not a 24-hour test - doc has not wanted one, yet. I did not mention that an earlier urine test (not 24-hour) in November that kicked off this 'ride' showed <0.01 g/l of IgG kappa detected in urine with overall urine protein of 0.04 g/l (0.0-0.20). The subsequent test was zero but from a different lab. I will ask him when I see him this week.
LSM was also normal (no numbers given).
No sickness at all apart from one urinary tract Infection that cleared with antibiotics back around July 2015. No colds; had the flu shot in April.
However, I had a dose of salmonella this year that put me on IV antibiotics and hospitalised in May. I look back now and those blood results were not normal yet nothing was said by doctor and I didn't ask. I have queried if these events are related and current specialist says no as this would have been building for a while. Very old blood tests show some elevation in total protein occasionally, but borderline. Coincidence?
I do wonder if the salmonella has kicked this off but I am not a doctor. I now want to unkick it!
I have a had a stressful year with a family issue and in very demanding job for 6 months that interrupted my sleep and increased my anxiety. Again, too much of a coincidence?
Thankyou again.
Re: What diagnosis do my lab results suggest?
MaggieDog, the question of specialists in Melbourne, Australia came up a few weeks ago from another member. Here is a link to the forum thread:
"Multiple myeloma specialist - Melbourne Australia?" (started March 12, 2015)
"Multiple myeloma specialist - Melbourne Australia?" (started March 12, 2015)
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: What diagnosis do my lab results suggest?
Hi Maggiedog,
Per your lab results that you first posted, the normal IgG range from your lab is 5.2-16 g/L (different labs will often vary on what they consider to be a normal range for any given maker). So, if your M-spike is truly 26 g/L, then the healthy component of your IgG level (1.1 g/L) is indeed pretty low.
Given that your doc has ordered a bone marrow biopsy, it is curious that he is holding off on doing a 24-hour urine test (aka 24 hour UPEP) as that is the urine-oriented test standard when it comes to diagnosing multiple myeloma – and it is a very inexpensive test to run. The kind of urine test you had is known as a random urine test and is not very useful or accurate in diagnosing multiple myeloma.
Per your lab results that you first posted, the normal IgG range from your lab is 5.2-16 g/L (different labs will often vary on what they consider to be a normal range for any given maker). So, if your M-spike is truly 26 g/L, then the healthy component of your IgG level (1.1 g/L) is indeed pretty low.
Given that your doc has ordered a bone marrow biopsy, it is curious that he is holding off on doing a 24-hour urine test (aka 24 hour UPEP) as that is the urine-oriented test standard when it comes to diagnosing multiple myeloma – and it is a very inexpensive test to run. The kind of urine test you had is known as a random urine test and is not very useful or accurate in diagnosing multiple myeloma.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What diagnosis do my lab results suggest?
Thanks to both of you. Bone marrow biopsy was yesterday. It was fine.
6 posts
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