My doctor tested me for Celiacs Disease because of some tummy problems. The test came up negative for Celiacs but IgA levels were elevated. The doctor ordered a SPE test which showed an M-Spike in the gamma region of 10.6% 0.7 g/dl. She then ordered a full skeletal survey. The results came back today. I have a 8mm focal lytic lesion in my C2 vertebrae. I go in for an MRI next week to investigate the lesion. I do not have bone pain. No Anemia. No calcification and no indicators for renal issues. I have been having night sweats. I have also had problems kicking a cold from earlier in the year. No other bone lesions.
I am being referred to a hematologist. I see her in 2 weeks.
I am not sure how to interpret all of this. I know I fall somewhere on the spectrum of MGUS and possible Multiple Myeloma. I am trying to understand what they will be looking for in the MRI. What would rule out a benign lesion versus an indication of bone involvement with multiple myeloma?
Also, I assume that the hematologist will perform more tests to identify what specific type of MGUS or multiple myeloma we could be looking at.
Not sure what I am asking for here, but if anyone has information to share then I would appreciate it.
Thanks!
Sillz
Forums
7 posts
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sillz - Name: Beth
- Who do you know with myeloma?: I might have MGUS
- When were you/they diagnosed?: November 2013
- Age at diagnosis: 47
Re: M-Spike Detected in Routine Blood Test
The MRI will help better confirm the actual presence and nature of the suspect lesion. It may not be myeloma-related or it may possibly be what is known as a solitary plasmacytoma, which is usually just treated with radiation and involves no chemo treatment.
https://myelomabeacon.org/news/2012/05/04/solitary-bone-plasmacytoma/
At this point, your doc should also order the additional serum and urine lab tests outlined here:
http://myeloma.org/ArticlePage.action?tabId=1&menuId=322&articleId=3177&aTab=-1
The above will help you determine if you meet any of the CRAB criteria. If you have no CRAB issues, and there is only one lesion, it may just be a solitary plasmacytoma (or something not even to worry about)...but your doc will need to make that determination.
You should also be getting a bone marrow biopsy and accompanying FISH test given the results you have thus far. This will help determine the extent of any cancer involvement inside your bones (measures the level of monoclonal plasma cells in your bone). This test, coupled with the other lab tests I mentioned above, will help with the staging of the disease. The FISH test will tell you if you have any genetic variations that could impact the potential course and treatment of the disease in the future.
Your M-spike is pretty low and you may just have MGUS or smoldering multiple myeloma and and may be fine for the rest of your life. I know its tough to wait for all results to sort all this out, but hang in there.
https://myelomabeacon.org/news/2012/05/04/solitary-bone-plasmacytoma/
At this point, your doc should also order the additional serum and urine lab tests outlined here:
http://myeloma.org/ArticlePage.action?tabId=1&menuId=322&articleId=3177&aTab=-1
The above will help you determine if you meet any of the CRAB criteria. If you have no CRAB issues, and there is only one lesion, it may just be a solitary plasmacytoma (or something not even to worry about)...but your doc will need to make that determination.
You should also be getting a bone marrow biopsy and accompanying FISH test given the results you have thus far. This will help determine the extent of any cancer involvement inside your bones (measures the level of monoclonal plasma cells in your bone). This test, coupled with the other lab tests I mentioned above, will help with the staging of the disease. The FISH test will tell you if you have any genetic variations that could impact the potential course and treatment of the disease in the future.
Your M-spike is pretty low and you may just have MGUS or smoldering multiple myeloma and and may be fine for the rest of your life. I know its tough to wait for all results to sort all this out, but hang in there.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: M-Spike Detected in Routine Blood Test
Thanks Billy. The links you sent were very helpful.
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sillz - Name: Beth
- Who do you know with myeloma?: I might have MGUS
- When were you/they diagnosed?: November 2013
- Age at diagnosis: 47
Re: M-Spike Detected in Routine Blood Test
Your story is exactly how i started on this journey! I went in for my routine physical, mentioned a tummy complaint, so they sent a Celiac panel and my IGA was really low. Followed by the very low M spike, trip to the local hematologist, etc, etc. Turned out I have smoldering multiple myeloma.
I will give you the same advice. Breath! Don't panic! Try to take it one step at a time.
And DONT SURF THE INTENET! Stay on reliable sites like "the myeloma beacon" and the international myeloma foundation websites. They have all the up to date info and great teaching articles.
As you get your results and have questions post them on the beacon which is monitored by physicians who may respond with knowledge and advice.
They were a god-send to me, hopefully you wont even need them!
All the best !
I will give you the same advice. Breath! Don't panic! Try to take it one step at a time.
And DONT SURF THE INTENET! Stay on reliable sites like "the myeloma beacon" and the international myeloma foundation websites. They have all the up to date info and great teaching articles.
As you get your results and have questions post them on the beacon which is monitored by physicians who may respond with knowledge and advice.
They were a god-send to me, hopefully you wont even need them!
All the best !
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mrsv118 - Name: Kate
- Who do you know with myeloma?: ME
- When were you/they diagnosed?: 7/19/12
- Age at diagnosis: 48
Re: M-Spike Detected in Routine Blood Test
Hi Kate,
It was hard to resist scouring the internet to research all of this – especially since I had never heard of Myeloma or MGUS. Luckily, I ran across this website and forum early in the process. I am using it as my main source of information. I am honestly not too freaked out. I am concerned though, and I want to make sure that I am being proactive by educating myself as much as I can. This forum is a great resource. Thank you for your words of encouragement and for the good advice.
Beth
It was hard to resist scouring the internet to research all of this – especially since I had never heard of Myeloma or MGUS. Luckily, I ran across this website and forum early in the process. I am using it as my main source of information. I am honestly not too freaked out. I am concerned though, and I want to make sure that I am being proactive by educating myself as much as I can. This forum is a great resource. Thank you for your words of encouragement and for the good advice.
Beth
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sillz - Name: Beth
- Who do you know with myeloma?: I might have MGUS
- When were you/they diagnosed?: November 2013
- Age at diagnosis: 47
Re: M-Spike Detected in Routine Blood Test
I got good news today. I saw the hematologist. They diagnosed me with MGUS. They did not recommend a bone marrow biopsy because my M-spike was so low. They didn't suggest a full body MRI. They want me to come in again in 3 months. They ordered SPEP, S Immunofixation, CBC w Diff w Plt and Complete Metabolic Panel. We pushed for the bone marrow test and full MRI, but they were very firm that it wasn't necessary at this point. The M-spike was .7 g/dl in November.
Does this sound about right?
Does this sound about right?
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sillz - Name: Beth
- Who do you know with myeloma?: I might have MGUS
- When were you/they diagnosed?: November 2013
- Age at diagnosis: 47
Re: M-Spike Detected in Routine Blood Test
Yes, Beth, a relatively low M-spike is good news.
However, I would still personally push for a bone marrow biopsy and full body xray (MRI preferred if you can get it) as a baseline and to make sure nothing else is up. I'm also not sure how they can definitively diagnose you as MGUS without the biopsy (my plasma % from my biopsy is what pushed me over the edge to smoldering from MGUS when I first got diagnosed). You should also be getting a freelite chain assay to see what's up with those guys. I assume they already tested your inviividual quantitative immunogloblulin levels (IgG, IgA, etc)?
Is your hematologist a multiple myeloma specialist that sees a lot of multiple myeloma patients on a daily basis? If not, I might suggest looking for one that would agree to the additional tests. Anyway, that's my personal opinion. Others on this site may have a different opinion.
However, I would still personally push for a bone marrow biopsy and full body xray (MRI preferred if you can get it) as a baseline and to make sure nothing else is up. I'm also not sure how they can definitively diagnose you as MGUS without the biopsy (my plasma % from my biopsy is what pushed me over the edge to smoldering from MGUS when I first got diagnosed). You should also be getting a freelite chain assay to see what's up with those guys. I assume they already tested your inviividual quantitative immunogloblulin levels (IgG, IgA, etc)?
Is your hematologist a multiple myeloma specialist that sees a lot of multiple myeloma patients on a daily basis? If not, I might suggest looking for one that would agree to the additional tests. Anyway, that's my personal opinion. Others on this site may have a different opinion.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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