I am new to this site, having been diagnosed at Stage I in June 2013. After reading many posts here on the forum, I decided that it would be best to seek a second opinion with a myeloma specialist. He concurred with my other oncologist on he diagnosis and treatment plan. Because he is a specialist in this disease, I will be switching my care to him. Currently, my treatment is "wait and see" with visits for lab tests every three months.
His nurse called yesterday and left word on my voicemail that the current labs were stable and that my M protein was .83. I have no idea what that means and because I wasn't able to speak to her before she left for the day, I wasn't able to ask.
Is a .83 considered low? I guess I really need some advice as to what an M Protein number means and whether a .83 is a good number.
Thanks so much!
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Cindy Lee - Name: Cindy Lee
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 64
Re: M Protein?
The normal value for the M Protein is zero. In the multiple myeloma world, an M-spike of 0.8 is not high. What the doctors will be watching is the trending of that lab - does it stay fairly stable, or does it rise. A rising M-Spike would be indicative of increasing myeloma cells.
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rumnting - Who do you know with myeloma?: husband
- When were you/they diagnosed?: 4/9/11
- Age at diagnosis: 54
Re: M Protein?
Hi Cindy Lee,
Welcome to the forum.
First off, an M-Spike of 0.83 g/dL is indeed a relatively low number, so that is great. I assume you had a bone marrrow biopsy and you know your plasma cell % from that test?
It's not easy to tell how you have been classified since your provided only the ISS Stage (you say your are "Stage 1"). I'm guessing from your M-Spike and the fact that both of your docs are saying "wait and see" that you have no CRAB (high Calcium, Renal (kidney), Anemia or Bone lesion) issues and that you are classified as MGUS, perhaps smoldering as a worst case (depending on your bone marrow biopsy results)?
As rumnting says, it's all about (longer term) trends. You'll undoubtedly see some normal ups and downs of your various markers along the way, but it will be the longer term trends that you and your doc will look at over time.
Welcome to the forum.
First off, an M-Spike of 0.83 g/dL is indeed a relatively low number, so that is great. I assume you had a bone marrrow biopsy and you know your plasma cell % from that test?
It's not easy to tell how you have been classified since your provided only the ISS Stage (you say your are "Stage 1"). I'm guessing from your M-Spike and the fact that both of your docs are saying "wait and see" that you have no CRAB (high Calcium, Renal (kidney), Anemia or Bone lesion) issues and that you are classified as MGUS, perhaps smoldering as a worst case (depending on your bone marrow biopsy results)?
As rumnting says, it's all about (longer term) trends. You'll undoubtedly see some normal ups and downs of your various markers along the way, but it will be the longer term trends that you and your doc will look at over time.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: M Protein?
Thank you for your responses. They are very helpful. My doctor arrived at Stage 1 based on:
Plasma cell percentage - 20%
Plasmacytoma of the scapula (not extramedullary) - treated with radiation therapy.
The cytogenetic tests put me in the "low risk" category.
Do the above factors put me in either the MGUS or smoldering classification?
Thank you for your insight. It is much appreciated.
Plasma cell percentage - 20%
Plasmacytoma of the scapula (not extramedullary) - treated with radiation therapy.
The cytogenetic tests put me in the "low risk" category.
Do the above factors put me in either the MGUS or smoldering classification?
Thank you for your insight. It is much appreciated.
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Cindy Lee - Name: Cindy Lee
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 64
Re: M Protein?
First, it's great that you have good cytogenetics. This plays a big role in prognosis and treatment.
I now think I know why your doc is talking in terms of Stage 1. Ignore my earlier comments about MGUS and Smoldering Myeloma because I didn't know you had a plasmacytoma. There are a few things you need to understand here.
One is the categorization of the disease, which can generally be MGUS, Smoldering (asymptomatic) and symptomatic multiple myeloma. Then there is the staging of the disease, which can be determined by Durie-Salmon or ISS criteria. The staging is technically based on some different criteria than what you mention here, but you have a bit of a unique case. You can get a quick overview of categorization and staging here:
http://en.wikipedia.org/wiki/Multiple_myeloma
But in your situation, it sounds like you have a single plasmacytoma (a malignant tumor) on your scapula, which is a special case. Technically to be classified as having a "solitary plasmacytoma", which is sort of its own unique classification of multiple myeloma, your plasma percentage needs to be less than 10%. In your case with a 20% plasma cell level, one then talks in terms of being classified as Stage 1 multiple myeloma. You can find a good description of this classification and treatment options here:
https://myelomabeacon.org/news/2012/05/04/solitary-bone-plasmacytoma/
Given that you are going to get radiation treatment of the plasmacytoma (at least I think you are based on your last post), you're not really in a "wait or see" mode. You will be actively treating the plasmacytoma (tumor) with radiation and will then "wait and see" if this takes care of the plasmacytoma issue or wait for any other CRAB criteria to develop before initiating any sort of treatment such as chemo. Your doc will then be scheduling you for both regular bloodwork and periodic full skeletal survey xrays to monitor the disease and will be looking at a number of factors in your bloodwork to keep tabs on you.
The radiation treatment of the plasmacytoma may be all that you ever need and you may just go on as you currently are for the rest of your life.
Make sense?
I now think I know why your doc is talking in terms of Stage 1. Ignore my earlier comments about MGUS and Smoldering Myeloma because I didn't know you had a plasmacytoma. There are a few things you need to understand here.
One is the categorization of the disease, which can generally be MGUS, Smoldering (asymptomatic) and symptomatic multiple myeloma. Then there is the staging of the disease, which can be determined by Durie-Salmon or ISS criteria. The staging is technically based on some different criteria than what you mention here, but you have a bit of a unique case. You can get a quick overview of categorization and staging here:
http://en.wikipedia.org/wiki/Multiple_myeloma
But in your situation, it sounds like you have a single plasmacytoma (a malignant tumor) on your scapula, which is a special case. Technically to be classified as having a "solitary plasmacytoma", which is sort of its own unique classification of multiple myeloma, your plasma percentage needs to be less than 10%. In your case with a 20% plasma cell level, one then talks in terms of being classified as Stage 1 multiple myeloma. You can find a good description of this classification and treatment options here:
https://myelomabeacon.org/news/2012/05/04/solitary-bone-plasmacytoma/
Given that you are going to get radiation treatment of the plasmacytoma (at least I think you are based on your last post), you're not really in a "wait or see" mode. You will be actively treating the plasmacytoma (tumor) with radiation and will then "wait and see" if this takes care of the plasmacytoma issue or wait for any other CRAB criteria to develop before initiating any sort of treatment such as chemo. Your doc will then be scheduling you for both regular bloodwork and periodic full skeletal survey xrays to monitor the disease and will be looking at a number of factors in your bloodwork to keep tabs on you.
The radiation treatment of the plasmacytoma may be all that you ever need and you may just go on as you currently are for the rest of your life.
Make sense?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: M Protein?
Thank you, Multibilly. It all makes perfect sense - thank you for your input. I did the radiation therapy last August.
When I completed the radiation therapy, I was of course wondering if that was it and the end of my worries about myeloma. I asked the radiology oncologist if it was a solitary plasmacytoma and if the radiation would take care of everything. He said, "No, it is not solitary because your other tests indicate it isn't." He told me that I had other lesions, but at this point, they are too small to be detected.
So I guess that is the "wait and see part of my treatment." Now that I know what the M Protein is all about - thanks to the wonderful responses here on the forum - I will be able to understand and have a starting point to gauge everything by in the future.
When I completed the radiation therapy, I was of course wondering if that was it and the end of my worries about myeloma. I asked the radiology oncologist if it was a solitary plasmacytoma and if the radiation would take care of everything. He said, "No, it is not solitary because your other tests indicate it isn't." He told me that I had other lesions, but at this point, they are too small to be detected.
So I guess that is the "wait and see part of my treatment." Now that I know what the M Protein is all about - thanks to the wonderful responses here on the forum - I will be able to understand and have a starting point to gauge everything by in the future.
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Cindy Lee - Name: Cindy Lee
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 64
6 posts
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