I am expecting to have a stem cell transplant (SCT) some time near June or July, but my doctor keeps saying if my numbers are within range and my body cooperates. It seems crazy but I don't know what this means or entails. I have all types of lab work done on a weekly basis and but the doctor doesn't explain what the numbers indicate, what range he expects the numbers to hit, or the importance of the numbers.
Most of my knowledge comes from google and when I talk to my doctor he tells me "stop googling information because it's only going to produce more anxiety and most of the information doesn't apply to you anyway".
So can anyone please help me make sense of my numbers?
(columns in tables below are: test name, normal range, my results)
WBC Diff
Neutrophils %, automated count 42.0-75.0 % 76.0
Lymphocytes %, automated count 20.0-51.0 % 14.0
Monos %, AUTO 1.0-12.0 % 9.7
Eosinophils %, automated count 0.0-10.0 % 0.2
Basophils %, automated count 0.0-1.0 % 0.1
RBC nucleated auto count, BLD <=0 % 1
Neutrophils, absolute, auto count 1.8-7.7 x1000/mcL 6.3
Lymphocytes, automated count 1.2-3.4 x1000/mcL 1.2
Monocytes, automated count 0.1-1.0 x1000/mcL 0.8
Eosinophils, automated count 0.0-0.7 x1000/mcL 0.0
Basophils, automated count 0.0-0.2 x1000/mcL 0.0
Immuno G A M, Kappa, Lambda
IgG 700-1600 mg/dL 414 (prev 461)
IgA 70-400 mg/dL 3600 (prev 4350)
IgM 40-230 mg/dL <17 (prev <18)
Kappa free light chain 3-19 mg/L 950 (prev 2270)
Lambda free light chain 6-26 mg/L 6 (prev 12)
Kappa/lambda ratio 0.3-1.7 158.3 (prev 189.2)
CBC Complete w/ Diff
WBC'S auto 4.0-11.0 x1000/mcL 8.2
RBC, auto 4.20-5.40 Mill/mcL 3.75
HGB 12.0-16.0 g/dL 10.8
HCT, auto 37.0-47.0 % 33.8
MCV 81.0-99.0 fL 90.1
MCH 27.0-35.0 pg/cell 28.8
MCHC 32.0-37.0 g/dL 32.0
RDW, blood 11.5-14.5 % 18.5
Platelets, automated count 130-400 x1000/mcL 201
Forums
10 posts
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
Re: What lab results do I need to have for a SCT?
Shari,
I might suggest seeking out a multiple myeloma specialist that will take the time to explain things to you, especially if you are considering an SCT. If you let us know which city you are in, folks on this forum can make some suggestions on where to find some good specialists.
Having said that, it looks like you have IgA-kappa type multiple myeloma since your IgA and kappa are both elevated. And each of these numbers are pretty elevated. Your IgM also looks like it is suppressed, which can often happen with multiple myeloma due to a condition called immunoparesis.
You have a pretty high free light chain ratio of 158.3. Recent guidelines suggest that a ratio over 100 is considered to a "myeloma defining event". This would make you considered to be "symptomatic" by the new International Myeloma Working Group standards, and therefore potentially requiring treatment. See the handbook below.
You are somewhat anemic due to your low hemoglobin, but not officially "anemic" by multiple myeloma standards.
You should also be looking at your calcium and creatinine levels on your other tests to see if you might be hypercalcemic or have any kidney issues going on (see the "CRAB" criteria in the handbook below). And, as you mentioned before, you need to locate your SPEP test to get your M-spike.
Have you had a bone marrow biopsy? Have you had a full skeletal xray survey, MRI or a PET/CT scan? .These would be very standard tests to have done in your situation.
I might suggest seeking out a multiple myeloma specialist that will take the time to explain things to you, especially if you are considering an SCT. If you let us know which city you are in, folks on this forum can make some suggestions on where to find some good specialists.
Having said that, it looks like you have IgA-kappa type multiple myeloma since your IgA and kappa are both elevated. And each of these numbers are pretty elevated. Your IgM also looks like it is suppressed, which can often happen with multiple myeloma due to a condition called immunoparesis.
You have a pretty high free light chain ratio of 158.3. Recent guidelines suggest that a ratio over 100 is considered to a "myeloma defining event". This would make you considered to be "symptomatic" by the new International Myeloma Working Group standards, and therefore potentially requiring treatment. See the handbook below.
You are somewhat anemic due to your low hemoglobin, but not officially "anemic" by multiple myeloma standards.
You should also be looking at your calcium and creatinine levels on your other tests to see if you might be hypercalcemic or have any kidney issues going on (see the "CRAB" criteria in the handbook below). And, as you mentioned before, you need to locate your SPEP test to get your M-spike.
Have you had a bone marrow biopsy? Have you had a full skeletal xray survey, MRI or a PET/CT scan? .These would be very standard tests to have done in your situation.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What lab results do I need to have for a SCT?
I currently live in Harbor City, CA, Yes, I have had a bone marrow biopsy and according to the doctor I have stage 3 multiple myeloma, and the full skeletal xray survey showed some lesions on different parts of my body including one of my arms.
My calcium number is 8.7, my creatinine level is 1.10, and my glomerular filtration rate is 65, so for the most part all the other numbers tested stay within average range.
The MRI scan results came back "neg" and I have had 6 weeks of chemo shots in my stomach, Velcade. I am just worried the doctor will say I am not eligible for the SCT. I have had to postpone one of the chemo treatments due to being diagnosed with H-pylori. Is H-pylori a normal bacterial infection multiple myeloma patients incur on a regular basis?
My calcium number is 8.7, my creatinine level is 1.10, and my glomerular filtration rate is 65, so for the most part all the other numbers tested stay within average range.
The MRI scan results came back "neg" and I have had 6 weeks of chemo shots in my stomach, Velcade. I am just worried the doctor will say I am not eligible for the SCT. I have had to postpone one of the chemo treatments due to being diagnosed with H-pylori. Is H-pylori a normal bacterial infection multiple myeloma patients incur on a regular basis?
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
Re: What lab results do I need to have for a SCT?
Harbor City, eh? I grew up in the LA area.
There are quite a few different multiple myeloma specialists you can see in the LA area. Here is a link to some centers that have multiple myeloma specialists.
https://myelomabeacon.org/resources/treatment-centers/#California
I'm sure others on the forum that have used various specialists in So Cal can chime in on their favorite specialists in that area. Here is one thread with a discussion about USC and City of Hope.
https://myelomabeacon.org/forum/myeloma-specialists-los-angeles-san-francisco-t3513.html
While I am smoldering and live in Colorado, my specialist is Dr. Berenson in West Hollywood. He is a well-revered multiple myeloma specialist, but be clear that he is anti-transplant. He therefore may not be your cup of tea if you are absolutely set on an SCT. But I would still personally recommend seeing him, if only to hear his perspective on treatment and the disease relative to what you will hear from other specialists. Just Google "Berenson Oncology".
In any case, you have lots of possibilities for a second or third opinion in the LA area (or to be able to switch docs).
Others may be able to comment about your question regarding H-pylori.
There are quite a few different multiple myeloma specialists you can see in the LA area. Here is a link to some centers that have multiple myeloma specialists.
https://myelomabeacon.org/resources/treatment-centers/#California
I'm sure others on the forum that have used various specialists in So Cal can chime in on their favorite specialists in that area. Here is one thread with a discussion about USC and City of Hope.
https://myelomabeacon.org/forum/myeloma-specialists-los-angeles-san-francisco-t3513.html
While I am smoldering and live in Colorado, my specialist is Dr. Berenson in West Hollywood. He is a well-revered multiple myeloma specialist, but be clear that he is anti-transplant. He therefore may not be your cup of tea if you are absolutely set on an SCT. But I would still personally recommend seeing him, if only to hear his perspective on treatment and the disease relative to what you will hear from other specialists. Just Google "Berenson Oncology".
In any case, you have lots of possibilities for a second or third opinion in the LA area (or to be able to switch docs).
Others may be able to comment about your question regarding H-pylori.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What lab results do I need to have for a SCT?
Hi Shari,
So sorry your doctor is not answering your questions - that's not right. With myeloma, knowledge is power!
Just to add to Multibilly's comments. When you start the process for your SCT they will perform a whole bunch of additional tests to make sure you are strong enough to withstand the procedure. I remember EJ having cardiac and pulmonary function tests, and together we had to have a psych evaluation, but I'm sure that there were more tests than that as we were at the hospital for more than 12 hours! This may be in part what your doctor means when he says "and your body cooperates."
Also, I'm assuming you are still doing your induction therapy. You may feel a bit better if you compare previous test results to the ones you published here. Hopefully you can see your numbers improving as your treatment has progressed.
Good luck!
Lyn
So sorry your doctor is not answering your questions - that's not right. With myeloma, knowledge is power!
Just to add to Multibilly's comments. When you start the process for your SCT they will perform a whole bunch of additional tests to make sure you are strong enough to withstand the procedure. I remember EJ having cardiac and pulmonary function tests, and together we had to have a psych evaluation, but I'm sure that there were more tests than that as we were at the hospital for more than 12 hours! This may be in part what your doctor means when he says "and your body cooperates."
Also, I'm assuming you are still doing your induction therapy. You may feel a bit better if you compare previous test results to the ones you published here. Hopefully you can see your numbers improving as your treatment has progressed.
Good luck!
Lyn
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Christa's Mom - Name: Christa's Mom
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: September, 2010
- Age at diagnosis: 53
Re: What lab results do I need to have for a SCT?
Thank you Multibilly and Christa's Mom for your responses, I will look into the information and do more research. This site has been very instrumental in helping me through this journey.
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
Re: What lab results do I need to have for a SCT?
Hi Shari,
I was diagnosed with myeloma after being hospitalized in renal failure (creatinine at about 6 times the maximum normal) After one cycle of Velcade (4 weekly shots) I was hospitalized again in early October because of extreme dizziness. My myeloma specialist decided to stop my chemo for 4 weeks. She said my numbers were stable enough to do so. I restarted in November. The bloodwork for my November clinic visit was the last time I had a measurable M spike. In December my creatinine was back into normal range.
My point is that it is too early in your treatment to know what your numbers will be when a decision about SCT can be made. It may be a very obvious decision then.
Why worry about it when it's all guesswork now? It's pointless.
Heck, you might as well worry about being hit by a bus tomorrow.
I was diagnosed with myeloma after being hospitalized in renal failure (creatinine at about 6 times the maximum normal) After one cycle of Velcade (4 weekly shots) I was hospitalized again in early October because of extreme dizziness. My myeloma specialist decided to stop my chemo for 4 weeks. She said my numbers were stable enough to do so. I restarted in November. The bloodwork for my November clinic visit was the last time I had a measurable M spike. In December my creatinine was back into normal range.
My point is that it is too early in your treatment to know what your numbers will be when a decision about SCT can be made. It may be a very obvious decision then.
Why worry about it when it's all guesswork now? It's pointless.
Heck, you might as well worry about being hit by a bus tomorrow.
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cdnirene - Name: Irene S
- Who do you know with myeloma?: me
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 66
Re: What lab results do I need to have for a SCT?
Thanks cdnirene, I guess I am trying to rush the process along and really should just stop and enjoy life in the here and now. I also suffer from generalized anxiety, so that doesn't help matters either.
Thanks for the advice to just relax, I wish it was just as easy to do as to say.
Thanks for the advice to just relax, I wish it was just as easy to do as to say.
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
Re: What lab results do I need to have for a SCT?
Shari, maybe this post will help.
When I first learned I had myeloma, I decided I would focus my mental energies on what I could control, rather than what I couldn't control, i.e., the diagnosis. There were a lot of routine things to handle after my first hospital stay. I live alone. After I started getting dizzy spells and falling, I realized I needed to start preparing to sell my two-story house. I didn't feel safe. There was a lot of decluttering to do as my basement was full. I also met with a dietitian and learned what a renal-friendly diet involved. It was difficult, but the time I spent learning what foods to eat probably helped my kidney function to bounce back more quickly. It felt good to take back some of the control I lost when I first heard my diagnosis.
I think we will both will have to make a number of difficult decisions in the future. So figuring out how to control some of the stress related to trying to make those decisions is an important use of our time.
I don't know anything about general anxiety, but my question to you to answer to yourself is: How much energy have you expended in the past to try to reduce your level of stress?
In your situation, I probably would have tried self-hypnosis tapes / digital downloads, yoga classes, books or classes on self-meditation, etc. They are all worth a try. Taking positive action to try to reduce your stress should make you feel better.
When I first learned I had myeloma, I decided I would focus my mental energies on what I could control, rather than what I couldn't control, i.e., the diagnosis. There were a lot of routine things to handle after my first hospital stay. I live alone. After I started getting dizzy spells and falling, I realized I needed to start preparing to sell my two-story house. I didn't feel safe. There was a lot of decluttering to do as my basement was full. I also met with a dietitian and learned what a renal-friendly diet involved. It was difficult, but the time I spent learning what foods to eat probably helped my kidney function to bounce back more quickly. It felt good to take back some of the control I lost when I first heard my diagnosis.
I think we will both will have to make a number of difficult decisions in the future. So figuring out how to control some of the stress related to trying to make those decisions is an important use of our time.
I don't know anything about general anxiety, but my question to you to answer to yourself is: How much energy have you expended in the past to try to reduce your level of stress?
In your situation, I probably would have tried self-hypnosis tapes / digital downloads, yoga classes, books or classes on self-meditation, etc. They are all worth a try. Taking positive action to try to reduce your stress should make you feel better.
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cdnirene - Name: Irene S
- Who do you know with myeloma?: me
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 66
Re: What lab results do I need to have for a SCT?
Thanks again Cdnirene, I expend a lot more energy stressing than I do destressing. I have started a journal to help release stress as well as bought a few positive statements to post around my living space.
I currently rent a room from a friend and she tells me the exact same thing about my stress level toward issues beyond my control (i.e. myeloma). I have decided to set one hour aside daily to begin practicing self-meditation. I know it will benefit me greatly.
Thanks again!
I currently rent a room from a friend and she tells me the exact same thing about my stress level toward issues beyond my control (i.e. myeloma). I have decided to set one hour aside daily to begin practicing self-meditation. I know it will benefit me greatly.
Thanks again!
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Shari - Name: Shari
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 03/12/2015
- Age at diagnosis: 47
10 posts
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