We took my MIL to her first visit with the oncologist yesterday after receiving her multiple myeloma diagnosis last week. He did not commit to a definite stage of her myeloma, or a prognosis. He said that she is definitely stage 2 and maybe stage 3.
I was able to get a copy of her lab results and I am trying to make sense of what I should be paying attention to and tracking going forward. some of these numbers seem off the charts high and that concerns me (IGA, IGG, Lambda Light Chains, M Protein in particular). almost all of her results are outside of range and considered abnormal.
Protein Electrophoresis, Serum
Total Protein 11.9
Albumin 3.14
Alpha 1 Globulin Electrophoresis .30
Alpha 2 .65
Beta Globulin Electrophoresis 7.28
Gamma Globulin .44
M Protein, Serum 6.77
Immunoglobulins
IGG 413
IGA 6370
IGM <18
Kappa Lambda Light Chains Free w Ratio Serum
Kappa Light Chain Free 8
Lambda Light Chain Free, Ser/Plas 1800
Kappa Lambda Free Ratio <0.3
WBCs Auto 3.8
RBC Auto 2.95
HGB 10.3
HCT 30.9
MCV 104.7
MCH 34.8
MCHC 33.2
RDW, Blood 17.3
Platelets 256
Thanks for any insight or direction.
Forums
3 posts
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Gigi927 - Name: Gigi
- Who do you know with myeloma?: MIL
- When were you/they diagnosed?: July 2015
- Age at diagnosis: 78
Re: Making Sense of 1st set of Lab Results
Gigi-
I wouldn't worry so much about your mother's stage of myeloma because it really doesn't change how your mother will be treated, or not. The most important things are the blood test results, results of 24 hour urine, bone marrow biopsy results with notation of percentage of abnormal cells and results of gene testing.
I would also suggest that your mother have a second opinion from a myeloma specialist, if she isn't already seeing one. It is always good to have a specialist who only treats people with myeloma, on your team. That person is up to date on all of the available medications and combinations of medications, research, clinical trials, etc. They are usually found at research-oriented cancer centers in large hospitals and/or universities.
Your mother, or you, should ask for copies of the results of all of the tests that have been done at each appointment so that you can keep an eye on the trends of her condition as she begins treatment. Ask if her oncologist has a patient portal that posts results on line when you sign up for it.
All the best to your mother as she begins to navigate living with myeloma,
Nancy in Phila
I wouldn't worry so much about your mother's stage of myeloma because it really doesn't change how your mother will be treated, or not. The most important things are the blood test results, results of 24 hour urine, bone marrow biopsy results with notation of percentage of abnormal cells and results of gene testing.
I would also suggest that your mother have a second opinion from a myeloma specialist, if she isn't already seeing one. It is always good to have a specialist who only treats people with myeloma, on your team. That person is up to date on all of the available medications and combinations of medications, research, clinical trials, etc. They are usually found at research-oriented cancer centers in large hospitals and/or universities.
Your mother, or you, should ask for copies of the results of all of the tests that have been done at each appointment so that you can keep an eye on the trends of her condition as she begins treatment. Ask if her oncologist has a patient portal that posts results on line when you sign up for it.
All the best to your mother as she begins to navigate living with myeloma,
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: Making Sense of 1st set of Lab Results
Hi Gigi,
Nancy is right. As I understand it, the stage of a patient's disease at diagnosis doesn't really have much impact on how the disease is treated.
For tracking your mother-in-law's multiple myeloma, the key lab results you want to focus on are her M-spike and her (serum) free light chain results.
Someone who is healthy does not have an M-spike. This is because the M-spike measures the amount of "monoclonal" immunoglobulins in the blood. Only myeloma cells, and other "mutant" / unhealthy plasma cells, produce "monoclonal" immunoglobulins. So, ideally, you want her M-spike to go down to zero when she is treated.
A patient's M-spike won't always go down to zero with treatment. And, even if it does, it doesn't mean that there are no more myeloma cells in your mother's body. It does mean, however, that the myeloma has been pounded down quite a bit.
Free light chains are parts of immunoglobulin molecules that have broken off, or were never attached as part of an entire immunoglobulin molecule in the first place. Even people who have never had myeloma have free light chains. But healthy people have free light chain levels, and a free light chain ratio, that are within certain "normal" ranges.
Myeloma patients with lots of the disease in their body, on the other hand, overproduce one type of free light chain -- either lambda or kappa. So, ideally, you want treatment to bring that free light chain level down to the normal range, and you also want the ratio of the kappa and lambda free light chain levels to go back to the normal range as well.
There are other lab results that you'll want to watch as well. I usually recommend watching immunoglobulin levels (IgG, IgA, and IgM); hemoglobin; calcium; and creatinine levels. But the M-spike and free light chain levels are the most important.
If you report M-spike and free light chain levels here in the forum, by the way, it's useful to also include the units of the results, because they can vary from lab to lab and country to country. In the U.S., for example, the M-spike is measured as g/dL. In other countries, it's usually measured as g/L; you need to divide those numbers by 10 to get the equivalent U.S. results.
And, yes, your mother-in-law's M-spike is quite high, so it's important that she start treatment soon, if she hasn't already. This poll that was done last year here in the forum will give you a sense of what other myeloma patients had as M-spikes at diagnosis:
https://myelomabeacon.org/forum/weekly-poll-m-spike-at-diagnosis-2014-t3136.html
Good luck!
Nancy is right. As I understand it, the stage of a patient's disease at diagnosis doesn't really have much impact on how the disease is treated.
For tracking your mother-in-law's multiple myeloma, the key lab results you want to focus on are her M-spike and her (serum) free light chain results.
Someone who is healthy does not have an M-spike. This is because the M-spike measures the amount of "monoclonal" immunoglobulins in the blood. Only myeloma cells, and other "mutant" / unhealthy plasma cells, produce "monoclonal" immunoglobulins. So, ideally, you want her M-spike to go down to zero when she is treated.
A patient's M-spike won't always go down to zero with treatment. And, even if it does, it doesn't mean that there are no more myeloma cells in your mother's body. It does mean, however, that the myeloma has been pounded down quite a bit.
Free light chains are parts of immunoglobulin molecules that have broken off, or were never attached as part of an entire immunoglobulin molecule in the first place. Even people who have never had myeloma have free light chains. But healthy people have free light chain levels, and a free light chain ratio, that are within certain "normal" ranges.
Myeloma patients with lots of the disease in their body, on the other hand, overproduce one type of free light chain -- either lambda or kappa. So, ideally, you want treatment to bring that free light chain level down to the normal range, and you also want the ratio of the kappa and lambda free light chain levels to go back to the normal range as well.
There are other lab results that you'll want to watch as well. I usually recommend watching immunoglobulin levels (IgG, IgA, and IgM); hemoglobin; calcium; and creatinine levels. But the M-spike and free light chain levels are the most important.
If you report M-spike and free light chain levels here in the forum, by the way, it's useful to also include the units of the results, because they can vary from lab to lab and country to country. In the U.S., for example, the M-spike is measured as g/dL. In other countries, it's usually measured as g/L; you need to divide those numbers by 10 to get the equivalent U.S. results.
And, yes, your mother-in-law's M-spike is quite high, so it's important that she start treatment soon, if she hasn't already. This poll that was done last year here in the forum will give you a sense of what other myeloma patients had as M-spikes at diagnosis:
https://myelomabeacon.org/forum/weekly-poll-m-spike-at-diagnosis-2014-t3136.html
Good luck!
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