[Lev]

M-spike & FLC improvement without treatment?

by Lev on Sun Nov 22, 2015 2:40 pm

Hello everybody

It is now 1 year past my ASCT and I have written a lot about that process here, so I will try to be brief here: "Well, not so bad so far."

I have decided to ask the doctor who is responsible for my treatment a lot of questions, and I have also decided to wait until February when I have the results for the +1 year bone marrow biopsy.

But at the same time I am wondering about the development of the M-spike and the kappa-lambda ratio. They started dropping even before the treatment began. And during treatment the drop continued. I feel that I am not able to tell whether the numbers would also have reached "0" / normal without the autologous stem cell transplant (ASCT) and this make me curious.

Is it common to see a very significant drop in multiple myeloma indicators before treatment has even started, or without treatment at all?

BEFORE TREATMENT
June 14, 2014
Kappa/lambda free light chain ratio: 4.06
Kappa free light chain level: 192
Lambda free light chain level: 47.3
M-component: 22.7 g/L (2.27 g/dL)

July 10, 2014 (Still Without any Treatment)
Kappa/lambda free light chain ratio: 3.0 down from 4.06
Kappa free light chain level: 129 down from 192
Lambda free light chain level: 43 down from 47.3
M-component: 12.5 g/L (1.25 g/dL), down from 22.7 g/L

August 6, 2014 (Still Without Treatment)
Kappa/lambda free light chain ratio: 1.77 down from 3.0 and from 4.06
Kappa free light chain level: 90.1 down from 129 and from 192
Lambda free light chain level: 51 up from 43 and from 47.3
M-component: 8.3 g/L (0.83 g/dL), down from 12.5 and from 22.7

AFTER START OF TREATMENT
November 28, 2014 - After Induction wit VCD, but before ASCT
Kappa/lambda free light chain ratio: 0.54 down from 1.77 and from 3.0 and from 4.06
Kappa free light chain level: 20.1 down from 90.1 and from 129 and from 192
Lambda free light chain level: 37.5 down from 51 and from 43 and from 47.3
M-component: 0.0 g/L (0 g/dL) down from 8.3 and from 12.5 and from 22.7 g/L

After ASCT the numbers have remained within the normal levels - and 0 M-component.

I hope you understand the question, and that I am wondering. Is it normal that the numbers drop so much without treatment? And of course I also am wondering if I could have done without the stem cell transplant.

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Moderator's Note: For another forum discussion with a topic similar to this one, please see:

"Can paraproteins (M-spike) drop without treatment?"

[JPC]

Re: M-spike & FLC improvement without treatment?

by JPC on Sun Nov 22, 2015 4:25 pm

Hello Lev:

Are you saying that you took NOTHING before the ASCT, and you numbers dropped???

Most patients would get one of the induction regimens (doublet or triplet) before ASCT.

Regards, JPC

[Multibilly]

Re: M-spike & FLC improvement without treatment?

by Multibilly on Sun Nov 22, 2015 6:39 pm

Lev,

Perhaps it was the ludefisk that your aunt gave you before the holidays?

[Lev]

Re: M-spike & FLC improvement without treatment?

by Lev on Sun Nov 22, 2015 10:41 pm

JPC,

Sorry if I was not clear here. I got 3 cycles of VCD before ASCT.

But the numbers dropped as I describe here BEFORE starting the VCD induction treatment (M-component fell from 22.7 g/ltr to 8.3 g/ltr) before treatment and then to zero after 3 cycles of induction.

Best regards,

Lev

[Lev]

Re: M-spike & FLC improvement without treatment?

by Lev on Sun Nov 22, 2015 10:56 pm

Multibilly wrote:

Perhaps it was the ludefisk that your aunt gave you before the holidays?

Oh dear, o dear

I am Danish, not Swedish.

At least mostly Danish. Half of my family are from Skåne just across the bridge and I still remember one Christmas as a child where we held the Christmas (here we celebrate on the eve of the 24th) in Malmø with my grandmother's sister and got ludfisk instead of the traditional Danish Christmas dinner.

But while I am still curious to whether it is normal to se the levels drop like this before starting treatment, I can only come up with two things I did during those two-three months up until starting treatment:
- had a vacation and probably drank on average one glass of very good red wine per day ... I usually drink very little, maybe two glasses per week.
- contrary to the advice not to carry any weight I took up windsurfing after not having been on the water for 7 years.

[Multibilly]

Re: M-spike & FLC improvement without treatment?

by Multibilly on Mon Nov 23, 2015 1:19 pm

Hi Lev,

I thought that godawful fish dish was to be found all over Scandinavia and the low countries, and not just Sweden

Seriously, I have no idea what to make of the drop in your numbers, which seem pretty substantial. Like I've said on several posts before, myeloma markers seem to move like the tides, but I'm not sure that would explain your numbers. It almost seems like you were on the path to becoming less secretory?

[Lev]

Re: M-spike & FLC improvement without treatment?

by Lev on Mon Nov 23, 2015 5:48 pm

Hi Multibilly,

Thanks for your always very well informed posts!

Yes, and I of course had to think: "What if I did not continue with the treatment ..."