[DallasGG]

Monoclonal protein blood test question

by DallasGG on Fri Sep 13, 2013 7:45 pm

I've gone through 2 rounds of VRD (Velcade, Revlimid, dex) treatments after being diagnosed in June. After the first round my monoclonal protein dropped from 4.0 g/dl to 0.8 g/dl. After the second round, I received the blood test results but there was no monoclonal protein reading listed on the results. but it said that there was "possible monoclonal protein the beta region." My doctor was not in the office but I was able to ask another doctor about the results and he said that after it drops below 0.5 g/dl, they have to do a more sensitive blood test or test the urine. I'm not sure if I interpreted his answer correctly (or understood it correctly). Does that make sense...that when the monoclonal protein drops below 0.5 g/dl, they have to do other more sensitive tests? Or maybe they just forgot to run the test for the monoclonal protein level?

[Wayne K]

Re: Monoclonal protein blood test question

by Wayne K on Sat Sep 14, 2013 5:52 pm

The 24 hour urine test is more sensitive. I always show a faint M1 in my serum and they determine the extent in my urine test.
I understand the process is nerve wracking and we all want answers to understand it, but I wouldn't assume anything beyond what the doctor tells you. One of my biggest confrontations, IMO, was with myself and assuming anything short of perfection was bad, but it isn't.

[Ron Harvot]

Re: Monoclonal protein blood test question

by Ron Harvot on Sat Sep 14, 2013 10:54 pm

The good news is your treatment is working and the m protein is falling!!

Ron

[Dr. Jason Valent]

Re: Monoclonal protein blood test question

by Dr. Jason Valent on Mon Sep 16, 2013 10:38 am

Many labs will have difficulty quantifying the M-protein when it is at low levels. The serum immunofixation test is often done to evaluate for low levels of protein. Also 24 hour urine tests can be done as well.

Most importantly, you are responding well. Keep it up!!

[lifeplan]

Re: Monoclonal protein blood test question

by lifeplan on Mon Sep 16, 2013 11:27 am

I have been having test done, my M spike is .08 and I have had the light chain and skeletal x ray done waiting on results. I am wondering is the M spike normal range or high

[DallasGG]

Re: Monoclonal protein blood test question

by DallasGG on Mon Sep 16, 2013 1:02 pm

Dr. Jason Valent wrote:
> Many labs will have difficulty quantifying the M-protein when it is at low
> levels. The serum immunofixation test is often done to evaluate for low
> levels of protein. Also 24 hour urine tests can be done as well.
>
> Most importantly, you are responding well. Keep it up!!

Thanks for your explanation. Being a new patient...there is still much to learn.

[DallasGG]

Re: Monoclonal protein blood test question

by DallasGG on Thu Oct 10, 2013 5:54 pm

I've just got the blood test results back after my 3rd round of VRD. The lab results say "immunoelectophoreseis shows no monoclonal immunogloblulins or monoclonal free light chains present" and "no monoclonal protein seen". I'm very pleased with the results so far. My question is...when you get to a monoclonal protein reading of zero, can you assume that the infected plasma percentage in the bone marrow has also dropped to zero? I'm guessing the answer is no but I just wanted to check with others here that have a zero reading and then had a bone marrow biopsy. What was your infected plasma percentage?

[Wayne K]

Re: Monoclonal protein blood test question

by Wayne K on Fri Oct 11, 2013 10:46 am

I've been at your level, but my information comes a little differently. They say that no M1 can detected, or sometimes it's "To faint to quantify". I think this probably reflects what is going on, it's still there but in such a small amount it can't be measured.

[Dr. Peter Voorhees]

Re: Monoclonal protein blood test question

by Dr. Peter Voorhees on Sun Oct 13, 2013 3:38 pm

Dear DallasGG,

You have had a great response!!!

You are in what I would call an unconfirmed complete remission. At this point, I would check the serum free light chain testing and repeat your bone marrow biopsy. Odds are that you have <5% plasma cells in your marrow at this point (which is within the normal range). The question is if the plasma cells there are myeloma plasma cells or normal plasma cells. Additional tests (flow cytometry and/or immunohistochemistry) on the marrow sample can sort this out.

If you have <5% plasma cells that are not myeloma plasma cells and the serum free light chain testing is normal, we would call that a stringent complete remission.

The bottom line is that you have had a wonderful response.

Keep up the good work!!!

Pete V.

[DallasGG]

Re: Monoclonal protein blood test question

by DallasGG on Sun Oct 13, 2013 4:03 pm

Thanks for your response!