[willow75]

Re: M-spike with high ratio: is it likely to be myeloma?

by willow75 on Fri Jan 26, 2018 5:19 pm

Dennis,

Congratulations on getting a lot of good results back on your blood tests!

One of my doctors told me that beta-2 microglobulin was prognostic but not diagnostic. In other words, it really isn't specific enough to indicate myeloma on its own, but it does contribute to the broader picture of what's going on. There are many conditions that can increase that number, including (I believe) certain kidney issues. This wasn't a huge jump.

I know it's hard, but try to look at the numbers as a complete picture. That's why this disease can take so long to diagnose and classify. If one number told the whole story, sorting out all the labs would be much less frustrating.

Hang in there!
-W

[dcj]

Re: M-spike with high ratio: is it likely to be myeloma?

by dcj on Sat Jan 27, 2018 9:44 pm

Thank you so much! This info is very helpful. Haven't hear from the oncologist yet. Some of the lab reports go directly to her. Hopefully on Monday. In the meantime, thanks for helping to put this into perspective.

DCJ

[dcj]

Re: M-spike with high ratio: is it likely to be myeloma?

by dcj on Mon Jan 29, 2018 5:13 pm

Greetings!

I just received the new monoclonal lab results and a note from the oncologist.

Last week, a lab result showed that my beta-2-microglobulin results were high (200-2300 ug/L). In November: 2,127 ug/L; January 2,409. My GFR rates and creatinine results were also higher, but within the band of chronic kidney disease since childhood.

Monoclonal protein results highs were (Oct 13 2017, Oct 18 2017, and Jan 25 2018):

Kappa Light Chain Free - 27.20 and 24.42 and 31.83
Lambda Light Chain Free - 12.56 and 12.04 and 12.86
Kapp/Lamb Fr- 2.17 and 2.03 and 2.48

Oct 13, 2017 and Jan 25, 2018 result comparison

IGG - 1070 and 1300
IGA - 60 and 72
IGM/Plas - 77 and 96

The results all seem to be slightly worse. As mentioned a few days ago in this string, other baseline blood tests were "normal."

The oncologist says that although the results are "slightly increased, they are not enough to cause kidney damage and that in her "point of view, your (my) MGUS is stable."

Does this make sense?

I appreciate the doctor's interpretation, but the "in her point of view" statement leaves room for question and alternate interpretations. Still stressing.

[willow75]

Re: M-spike with high ratio: is it likely to be myeloma?

by willow75 on Wed Jan 31, 2018 1:01 am

Dennis,

I don't have much expertise on MGUS, but I'm sorry for the worrying you are going through!

I think your doctor is acknowledging that there's always a bit of a judgment call and so she's telling you what her best judgment is. I personally would rather go to a doctor who hedges a little bit than one who seems overconfident, but people respond to different styles. Remember that you always have the option to seek out a second opinion.

If you haven't yet, you might also want to ask your doctor some more questions about what she is looking for and what her plans are in different scenarios. What would cause her to believe the MGUS was no longer stable? What would that change mean for you? If she's willing to engage in that discussion, it may put your mind at ease to have a better understanding of how this ship is being steered.

Good luck!
-W