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M-spike following radiation of bone plasmacytoma

by melissaanne on Tue Dec 01, 2015 8:45 pm

Hello All-

My mother completed 25 sessions of radiation to the spinal region in which her plasmacytoma was found. She had an M-spike of 0.3 g/dl at the time of diagnosis.

It has been 3 weeks since her radiation and her blood work showed that her M-spike has stayed at 0.3 g/dl (3 g/L). I have heard of an M-spike taking some time to decrease after radiation in plasmacytoma cases. Her oncologist feels it may just be too soon after radiation to tell.

He did say that if the M-spike stays the same, he will consider her case to be 'MGUS with plasmacytoma'. He still feels this is not multiple myeloma. I should add that her calcium is normal, no anemia, no kidney dysfunction, and her previous bone marrow biopsy came back at 5% plasma cells (no abnormal/clonal cells present). Her kappa light chains are slightly elevated, causing her ratio to be 2.30.

Thank you in advance! :)

melissaanne
Name: Melissa
Who do you know with myeloma?: My Mother
When were you/they diagnosed?: September 2015
Age at diagnosis: 49

Re: M-spike following radiation of bone plasmacytoma

by Multibilly on Tue Dec 01, 2015 9:20 pm

Hi Melissa,

It sounds like you are expecting an answer or a comment on this thread, but what exactly is your question?

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: M-spike following radiation of bone plasmacytoma

by melissaanne on Tue Dec 01, 2015 9:26 pm

Sorry. To clarify, I was curious if an M-spike takes a considerable amount of time to potentially decrease following radiation (or treatment of any kind for that matter). Does this value tend to be slow-moving?

Her oncologist mentioned it "may be too soon after radiation to tell" if her M-spike is responding (decreasing). I was hoping to get some clarification on if that's typical.

melissaanne
Name: Melissa
Who do you know with myeloma?: My Mother
When were you/they diagnosed?: September 2015
Age at diagnosis: 49

Re: M-spike following radiation of bone plasmacytoma

by Multibilly on Tue Dec 01, 2015 9:37 pm

I'm by no means an expert on SBPs, but this article implies that the M-spike can continue to decrease at least up to a year or two after therapy.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895544/

"...The M protein may decrease with successful therapy of SBP, and it has been reported that complete disappearance of the M protein 1 year after therapy is associated with prolonged disease stability"

"...For example, one of the most reliable predictors of progression, namely persistence of a serum M protein, can be assessed only a year or 2 following therapy and is therefore not available for risk assessment at the time of initial diagnosis."

There's actually a lot of gems in this article related to SBPs and prognosis, so you may want to take the time to read the entire article.
Last edited by Multibilly on Tue Dec 01, 2015 9:42 pm, edited 1 time in total.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: M-spike following radiation of bone plasmacytoma

by melissaanne on Tue Dec 01, 2015 9:39 pm

Perfect! Thank you Multibilly. I did some searches for similar articles but found none that seemed to address this specific situation. I will pass this on. Thanks!

melissaanne
Name: Melissa
Who do you know with myeloma?: My Mother
When were you/they diagnosed?: September 2015
Age at diagnosis: 49

Re: M-spike following radiation of bone plasmacytoma

by Little Monkey on Wed Dec 02, 2015 1:52 pm

There is a lot of wait and watch when it comes SBP post radiation treatment; the doctors do not want to start chemotherapy simply because of a slightly elevated k/l ratio when it may be a genuine case of SPB; the doctors, presumably, want to be certain it is multiple myeloma before they start chemotherapy.

Little Monkey
Name: Little Monkey
Who do you know with myeloma?: Father-stage 1 multiple myeloma
When were you/they diagnosed?: March/April of 2015

Re: M-spike following radiation of bone plasmacytoma

by melissaanne on Wed Dec 02, 2015 9:04 pm

LittleMonkey,

Thanks for the reply. I think your information pertains more to someone on the fence of multiple myeloma. My mom is currently SBP and possibly MGUS if her M-spike stays elevated. There is no evidence of myeloma currently, based on her other lab results and BMB.

melissaanne
Name: Melissa
Who do you know with myeloma?: My Mother
When were you/they diagnosed?: September 2015
Age at diagnosis: 49

Re: M-spike following radiation of bone plasmacytoma

by Little Monkey on Wed Dec 02, 2015 11:24 pm

melissaanne,

Just another question, has your mom had a PET scan yet?

Little Monkey
Name: Little Monkey
Who do you know with myeloma?: Father-stage 1 multiple myeloma
When were you/they diagnosed?: March/April of 2015


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