[Scared caught e t]

Multiple myeloma or chronic anemia?

by Scared caught e t on Sat Mar 26, 2016 12:51 am

My mother will be 84 in a few weeks. She has had low CBC as long as I can remember. She has been having more trouble getting around. Her primary ran a series of lab work to rule out multiple myeloma. They called to say that the light chains were elevated and it was multiple myeloma and that she would need a skeleton survey and skull xray before we see oncologist.

I faxed these results to a hematologist and he doesn't agree. He thinks it's chronic anemia.

What do we do?

[Multibilly]

Re: Multiple myeloma or chronic anemia?

by Multibilly on Sat Mar 26, 2016 8:07 am

Hi Scared caught e t,

Welcome to the forum. You might want to consider registering on this forum since it makes it much easier to find posts and for folks on the forum to help you.

You can't say with any certainty that one has a monoclonal gammopathy such as MGUS, smoldering multiple myeloma, or multiple myeloma, based on just having "elevated free light chain values" and a low hemoglobin level. Depending on the values of her serum free light chains, having those two conditions occur at the same time would warrant additional testing for a monoclonal gammopathy, IMHO.

A CBC includes many lab values. What exactly is her hemoglobin level? (Please include the units of measure and the normal range from the test.)

Did the doctor also run a serum immunofixation and a serum protein electrophoresis test? What were those results?

What exactly were her serum free light chain values? (Please include the units of measure and the normal ranges from the test.)

Also, what are her creatinine and calcium levesl (you can find these on the metabolic panel test ... please include the units of measure and the normal ranges from the tests).

Knowing these results will help others on the forum comment regarding the potential for a monoclonal gammopathy.

There are also quite a few additional lab tests that one can run to help diagnose a specific type of anemia. But I'm not at all qualified to comment on whether one's underlying anemia might be due to a monoclonal gammopathy or from some other form of anemia.

Last edited by Multibilly on Sat Mar 26, 2016 8:32 am, edited 1 time in total.

[JPC]

Re: Multiple myeloma or chronic anemia?

by JPC on Sat Mar 26, 2016 8:23 am

Hello scared:

I agree with Multibilly's advice. Let me add the following. It is possible to have the pre-myeloma conditions (MGUS or smoldering multiple myeloma), and also have an anemic condition (e.g. iron depletive anemia) that is not caused by the multiple myeloma. My wife was monitored for this for 8+ years. That is definitely a complication. It would have been a mistake to start the multiple myeloma treatment many years early. Eventually, it did evolve to active multiple myeloma, at which time naturally low anemia fell through the floor, and the M-spike started to rise much faster.

So get the tests, have it reviewed with multiple myeloma specialist, and see what to do. It does not sound like your mother at this time has any of the potentially bad multiple myeloma symptoms (a good thing), and mostly (though not always) multiple myeloma is a slow-moving condition, so in all likelihood you have the time you need to do that.

Another interesting point that you find out when you read up on it is that, as you get older, you are much more likely to have a very early stage pre-multiple myeloma condition called MGUS. I am not sure that there is precise data on it, but I have heard a doctor mention that probably more than half of the people walking around over 80 have a low level of MGUS that they do not know about, and that does not bother them.

Good luck.