My M-spike was 1.8 g/dL in my last blood work. I have mild anemia and mild hypercalcemia, so I meet two of the three CRAB criteria. I do have some light chain findings on blood work. Body scan shows no lesions and I am otherwise symptom free.
Given my anemia and hypercalcemia, is this still MGUS and is just monitoring blood every four months the best strategy at this point?
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Re: Is it MGUS or multiple myeloma?
Hi LAA,
The degree of anemia and hypercalcemia are very important to understand in determining if one technically meets any of any of the CRAB criteria. A lot of us who are smoldering or have MGUS have slightly off calcium, hemoglobin, and creatinine levels, but this doesn't mean that we necessarily meet the CRAB criteria and are considered symptomatic. Also, with anemia, it is important to understand just what the source of the anemia is. The anemia may not necessarily be caused by the MGUS - in which case it is not considered to be part of the CRAB criteria.
What exactly are your calcium and hemoglobin levels (including the normal ranges and units of measure for each of those two values)?
Have you ever had a bone marrow biopsy to measure your bone marrow plasma cell percentage?
The degree of anemia and hypercalcemia are very important to understand in determining if one technically meets any of any of the CRAB criteria. A lot of us who are smoldering or have MGUS have slightly off calcium, hemoglobin, and creatinine levels, but this doesn't mean that we necessarily meet the CRAB criteria and are considered symptomatic. Also, with anemia, it is important to understand just what the source of the anemia is. The anemia may not necessarily be caused by the MGUS - in which case it is not considered to be part of the CRAB criteria.
What exactly are your calcium and hemoglobin levels (including the normal ranges and units of measure for each of those two values)?
Have you ever had a bone marrow biopsy to measure your bone marrow plasma cell percentage?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Is it MGUS or multiple myeloma?
As of October 20, 2015:
My M-spike is 1.8 g/dl; reference range: not observed. (It has previously been as high as 2.1.)
Gamma Globulin: 2.1 g/dl compared to reference range: 0.5- 1.6
Calcium: 10.2 mg/dl reference range 8.6 - 10.0
Corrected calcium: 10.6 mg/dl; reference range: 8.6 - 10.0
HgB: 12.7 g/dl; reference range: 14.0 -18.0
New testing is to be done late this month.
My M-spike is 1.8 g/dl; reference range: not observed. (It has previously been as high as 2.1.)
Gamma Globulin: 2.1 g/dl compared to reference range: 0.5- 1.6
Calcium: 10.2 mg/dl reference range 8.6 - 10.0
Corrected calcium: 10.6 mg/dl; reference range: 8.6 - 10.0
HgB: 12.7 g/dl; reference range: 14.0 -18.0
New testing is to be done late this month.
Re: Is it MGUS or multiple myeloma?
To be anemic by CRAB standards, your hemoglobin needs to be < 10 g/dl or 2 g/dL under your lower lab limit (less than 12 g/dL in your case). To be hypercalcemic by CRAB standards, your calcium level needs to be greater than 11 mg/dL.
You will likely find that your lab values will vary quite a bit from test to test and from lab to lab. It's therefore really handy to graph your key lab values over time. You can get an idea of just how much my hemoglobin has varied as a smoldering multiple myeloma patient here:
https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-40.html#p35483
My calcium level varies quite a bit as well and has bounced between 8.8 and 10.5 mg/dL over the past three years.
So the message here is don't automatically assume that you are on a vector to become symptomatic based on only one or two sets of lab results.
You will likely find that your lab values will vary quite a bit from test to test and from lab to lab. It's therefore really handy to graph your key lab values over time. You can get an idea of just how much my hemoglobin has varied as a smoldering multiple myeloma patient here:
https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-40.html#p35483
My calcium level varies quite a bit as well and has bounced between 8.8 and 10.5 mg/dL over the past three years.
So the message here is don't automatically assume that you are on a vector to become symptomatic based on only one or two sets of lab results.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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