Hi, I have never used this site before and I have not been officially diagnosed yet, but my doctor thinks I have either MGUS or smoldering myeloma. He has not ordered a bone marrow biopsy but when I check my numbers it looks like I do have something. Which one, I don't know.
On my lab reports, these areas are considered abnormal:
Gamma Globulins, SPE 1.71 (High)
Beta Globulins, SPE, 1.27 (High)
Total Protein, Urine 5.0 *
Folates *14.9
Transferrin Saturation 14*
Total Binding Capacity 450 (High)
Calculated GFR >60.0 *
Anion Gap 9 *
MPV 9.8 (High)
Path Interpretation SPE: Slight polyclonal increase in globulin.
When I look up all these numbers, it seems to me to definitely show MGUS or SMM. Am I missing something? Should I find a different doctor since he said I am not diagnosed with anything, will just retest in 3 months?
I don't want to freak out, but they should be doing something and I don't want to ignore it either.
Any info helps, Thanks
Forums
7 posts
• Page 1 of 1
-
Brenda - Name: Brenda
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: not tecnically diagnosed yet
- Age at diagnosis: 48
Re: Do these lab results show MGUS or smoldering myeloma?
You don't appear to have anything concrete and the fact that he is going to test again in 3 months is a sign he doesn't intend to ignore it. I was on a 3 month schedule after my stem cell transplant and that was with the knowledge that I had multiple myeloma.
I know you are anxious and no one can blame you, but the doctor wants more.
I know you are anxious and no one can blame you, but the doctor wants more.
-
Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Do these lab results show MGUS or smoldering myeloma?
Hi Prochnow,
Welcome to the forum.
You mention "SPE". Is this your serum protein electrophoresis lab? In that report, there should be a stand alone sentence that describes if a paraprotein (aka M-Spike, monoclonal protein, M-Protein) is present. Or is this where it simply says "Slight polyclonal increase in globulin"?
BTW, you always want to include the units of measure when talking about lab results.
Wayne is right that a follow-up in 3 months is about right and it doesn' t sound like your doc is being dismissive.
Welcome to the forum.
You mention "SPE". Is this your serum protein electrophoresis lab? In that report, there should be a stand alone sentence that describes if a paraprotein (aka M-Spike, monoclonal protein, M-Protein) is present. Or is this where it simply says "Slight polyclonal increase in globulin"?
BTW, you always want to include the units of measure when talking about lab results.
Wayne is right that a follow-up in 3 months is about right and it doesn' t sound like your doc is being dismissive.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Do these lab results show MGUS or smoldering myeloma?
Thank you for your answers, I will try to clear some of numbers up:
Gamma Globulins SPE H 1.71 (.60 - 1.50)
Beta Globulins, SPE H 1.27 (.60 - 1.20)
Folates * 14.9 (5.4 - 40.0)
Ferritin L8 (10 - 130),
Total Iron Binding Capacity Calculated H 450 (250 - 400)
Transferrin Saturation * 14
LDH H 190 (91 - 180)
Calculated GFR * >60.0 ( >60.0)
MPV H 9.8 (6.0 - 9.5)
Path. Interpretation SPE: slight polyclonal increase in globulin.
Total Protein, Urine *5.0 (there is no range for this one)
Path. Interpretation SPE: normal UPE C. Moddrell .
And then on a different page there is a graph Serum Protein Electrophoresis. It shows a high spike with littler bumps.
Albumin 3.86 g.dL range of 3.40 - 4.80
Alpha 1 .27g/dL range of .20 - .60
Alpha 2 .79 g/dL range .30 - 1.00
Beta 1.27+ g/dL range of .60 -1.20
Gamma 1.71+ g/dL range of .60 - 1.50
Total 7.90 g/dL range 6.00 - 8.00
and on bottom it is handwritten: slight polyclonal increase in globulins.
I am assuming this is my M spike?
And then on Final Report it says
A. No abnormality identified in cell morphology or differential
B. Hemoglobin 13.6 g/dL
and under that
Paraproteinemia, anemia,
but there is nothing else with that, no numbers, no other words at all.
I have read a lot of info about it, and just trying to understand what everything means, but by reading everything it seems like he would have diagnosed me with MGUS or smoldering multiple myeloma, but he says he has not diagnosed me with anything.
Again thank you so much for responding.
Gamma Globulins SPE H 1.71 (.60 - 1.50)
Beta Globulins, SPE H 1.27 (.60 - 1.20)
Folates * 14.9 (5.4 - 40.0)
Ferritin L8 (10 - 130),
Total Iron Binding Capacity Calculated H 450 (250 - 400)
Transferrin Saturation * 14
LDH H 190 (91 - 180)
Calculated GFR * >60.0 ( >60.0)
MPV H 9.8 (6.0 - 9.5)
Path. Interpretation SPE: slight polyclonal increase in globulin.
Total Protein, Urine *5.0 (there is no range for this one)
Path. Interpretation SPE: normal UPE C. Moddrell .
And then on a different page there is a graph Serum Protein Electrophoresis. It shows a high spike with littler bumps.
Albumin 3.86 g.dL range of 3.40 - 4.80
Alpha 1 .27g/dL range of .20 - .60
Alpha 2 .79 g/dL range .30 - 1.00
Beta 1.27+ g/dL range of .60 -1.20
Gamma 1.71+ g/dL range of .60 - 1.50
Total 7.90 g/dL range 6.00 - 8.00
and on bottom it is handwritten: slight polyclonal increase in globulins.
I am assuming this is my M spike?
And then on Final Report it says
A. No abnormality identified in cell morphology or differential
B. Hemoglobin 13.6 g/dL
and under that
Paraproteinemia, anemia,
but there is nothing else with that, no numbers, no other words at all.
I have read a lot of info about it, and just trying to understand what everything means, but by reading everything it seems like he would have diagnosed me with MGUS or smoldering multiple myeloma, but he says he has not diagnosed me with anything.
Again thank you so much for responding.
-
Brenda - Name: Brenda
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: not tecnically diagnosed yet
- Age at diagnosis: 48
Re: Do these lab results show MGUS or smoldering myeloma?
Hmmm. First off, I'm not a doc, so one really needs to confirm all this.
A polyclonal increase in globulins is not the same as an M-Spike (which would be a monoclonal increase) and doesn't mean you have a monoclonal gammopathy. It instead suggests something like an infection. Seeing a "high spike and little bumps" in your SPE is normal...it just depends on where and what the bumps look like that tells you if it is an M-Spike or not.
You hemoglobin is on the low side, but your are not out of range, so this is probably why they say you might be anemic? You might want to also look at your Red Blood Cell (RBC) level to see if something is going on there for them to say you have "anemia".
But saying you have "paraproteinemeia" suggests a monoclonal gammopathy, but I'm not sure how they came up with that based on what you have here (maybe somebody else on the forum can figure that one out?). Was there another test called an "Immunofixation" that stated that you have monoclonal protein present (it wouldn't tell you how much, but it is very reliable in telling you if any is present)?
Was your urine test just a quick random sample or did your collect your urine for 24 hours?
In any case, your total serum proteins and your random urine proteins (assuming a random urine sample, the normal protein range is 0-8 mg/dL...depending on the lab) are in range, so it's not like you are looking at anything significant. If it is a monoclonal gammopathy, it is probably something like MGUS, which you could live with for the rest of your life and never be any the worse for it. But, I'm not sure it's even that based on what you have here.
So, I might suggest:
1. Get re-tested in 3 months, like your doc said.
2. Ask to have all the tests under Laboratory Tests done in this link so that you have a more complete picture:
http://myeloma.org/pdfs/IMF-U-TestResults-2011_f1web.pdf
3. Consider doing your follow-up with a hematologist that specializes in multiple myeloma. There is no substitute for having a specialist that lives and breathes monoclonal gammopathies to be involved with any initial diagnosis. If you let us know which city you are in, folks can make some recommendations on who to see.
4. Lastly, I can totally appreciate that waiting 3 months will be a drag. I think that this would drive me a bit crazy, so I might seek out a multiple myeloma specialist fairly quickly just so I could know where things stand and not have to worry about all this.
Again, I'm not a doc, so take everything I say with a grain of salt and please confirm it all with a doc. Best of luck to you.
A polyclonal increase in globulins is not the same as an M-Spike (which would be a monoclonal increase) and doesn't mean you have a monoclonal gammopathy. It instead suggests something like an infection. Seeing a "high spike and little bumps" in your SPE is normal...it just depends on where and what the bumps look like that tells you if it is an M-Spike or not.
You hemoglobin is on the low side, but your are not out of range, so this is probably why they say you might be anemic? You might want to also look at your Red Blood Cell (RBC) level to see if something is going on there for them to say you have "anemia".
But saying you have "paraproteinemeia" suggests a monoclonal gammopathy, but I'm not sure how they came up with that based on what you have here (maybe somebody else on the forum can figure that one out?). Was there another test called an "Immunofixation" that stated that you have monoclonal protein present (it wouldn't tell you how much, but it is very reliable in telling you if any is present)?
Was your urine test just a quick random sample or did your collect your urine for 24 hours?
In any case, your total serum proteins and your random urine proteins (assuming a random urine sample, the normal protein range is 0-8 mg/dL...depending on the lab) are in range, so it's not like you are looking at anything significant. If it is a monoclonal gammopathy, it is probably something like MGUS, which you could live with for the rest of your life and never be any the worse for it. But, I'm not sure it's even that based on what you have here.
So, I might suggest:
1. Get re-tested in 3 months, like your doc said.
2. Ask to have all the tests under Laboratory Tests done in this link so that you have a more complete picture:
http://myeloma.org/pdfs/IMF-U-TestResults-2011_f1web.pdf
3. Consider doing your follow-up with a hematologist that specializes in multiple myeloma. There is no substitute for having a specialist that lives and breathes monoclonal gammopathies to be involved with any initial diagnosis. If you let us know which city you are in, folks can make some recommendations on who to see.
4. Lastly, I can totally appreciate that waiting 3 months will be a drag. I think that this would drive me a bit crazy, so I might seek out a multiple myeloma specialist fairly quickly just so I could know where things stand and not have to worry about all this.
Again, I'm not a doc, so take everything I say with a grain of salt and please confirm it all with a doc. Best of luck to you.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Do these lab results show MGUS or smoldering myeloma?
Thank you Multibilly for your answers,
My RBC is 4.67 ref range is 4.00 - 5.40, I am not sure where he is coming up with the anemia part because they all seem to be in normal range to me, the only numbers that came up too high or low were what I posted. But I will be the first to say I have no idea what I am reading lol.
I did do the 24 hr urine test. And as far as I can tell they didn't do any Immunofixation test. If they did, I don't know which part it is.
I am seeing an oncologist in Lawrence Kansas and have thought about checking to see if there are doctors who specialize in multiple myeloma in Kansas City. As far as I know this doctor specializes in all cancers, not multiple myeloma, but can't be sure since I didn't ask, will be a question I ask.
The only other thing I see on my Peripheral Blood Path Review report is under where it says
Paraproteinemia, anemia
Microscopic Description
Erythrocytes are normochromic and normocytic without significant anisopoikilocytosis. No rouleaux formation is observed. Occasional stomatocytes are identified. Platelets appear normal in number and morphology. Leukocytes appear normal in number, morphology and in distribution. No circulating plasma cells are seen. No monomorphic lymphoid population is observed.
Differential: Segmented neutrophils 58; lymphocytes 35; monocytes 5; eosinophils 1; basophils1.
I am trying to NOT worry but when I went to the doctor I had no information, he just said that he suspected that I had MGUS or smoldering myeloma from a previous routine lab work from my regular doctor, but on looking at that report the only two number off are my
gamma globulin was 1.7 g/dL normal range is .5 - 1.6
and MCHC was 36.1g.dL normal range 32.0 - 36.0
and it seems like more of my numbers are off this time, so I am confused and I am trying to learn as much as I can so when I go back I will no what to ask, he doesn't seem to be willing to say much, so I need to know what to ask.
Again I thank you so much for all the info you have already provided.
My RBC is 4.67 ref range is 4.00 - 5.40, I am not sure where he is coming up with the anemia part because they all seem to be in normal range to me, the only numbers that came up too high or low were what I posted. But I will be the first to say I have no idea what I am reading lol.
I did do the 24 hr urine test. And as far as I can tell they didn't do any Immunofixation test. If they did, I don't know which part it is.
I am seeing an oncologist in Lawrence Kansas and have thought about checking to see if there are doctors who specialize in multiple myeloma in Kansas City. As far as I know this doctor specializes in all cancers, not multiple myeloma, but can't be sure since I didn't ask, will be a question I ask.
The only other thing I see on my Peripheral Blood Path Review report is under where it says
Paraproteinemia, anemia
Microscopic Description
Erythrocytes are normochromic and normocytic without significant anisopoikilocytosis. No rouleaux formation is observed. Occasional stomatocytes are identified. Platelets appear normal in number and morphology. Leukocytes appear normal in number, morphology and in distribution. No circulating plasma cells are seen. No monomorphic lymphoid population is observed.
Differential: Segmented neutrophils 58; lymphocytes 35; monocytes 5; eosinophils 1; basophils1.
I am trying to NOT worry but when I went to the doctor I had no information, he just said that he suspected that I had MGUS or smoldering myeloma from a previous routine lab work from my regular doctor, but on looking at that report the only two number off are my
gamma globulin was 1.7 g/dL normal range is .5 - 1.6
and MCHC was 36.1g.dL normal range 32.0 - 36.0
and it seems like more of my numbers are off this time, so I am confused and I am trying to learn as much as I can so when I go back I will no what to ask, he doesn't seem to be willing to say much, so I need to know what to ask.
Again I thank you so much for all the info you have already provided.
-
Brenda - Name: Brenda
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: not tecnically diagnosed yet
- Age at diagnosis: 48
Re: Do these lab results show MGUS or smoldering myeloma?
For multiple myeloma specialists in Kansas, see:
https://myelomabeacon.org/resources/treatment-centers/#Kansas
Others may have recommendations in the Kansas area.
It's worth getting at least an initial consult with a top multiple myeloma specialist. Nothing against general oncologists, but there really is a lot of nuance to multiple myeloma that a general oncologist simply can't keep up on.
https://myelomabeacon.org/resources/treatment-centers/#Kansas
Others may have recommendations in the Kansas area.
It's worth getting at least an initial consult with a top multiple myeloma specialist. Nothing against general oncologists, but there really is a lot of nuance to multiple myeloma that a general oncologist simply can't keep up on.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
7 posts
• Page 1 of 1