Hi everyone!
At this time last week, I didn't know what multiple myeloma was, but I have found myself scouring the Internet these past few days in search of answers and information. I have been reading through many posts on this forum and I have been impressed with both the knowledge and kindness displayed by the members. Thank you in advance for any helpful responses to my post.
Now on to my story.
My father, a very active 59 year old man, injured his neck while remodeling a closet in his home a few months ago. He complained of pain and discomfort for a few weeks before my mother dragged him to the doctor. A CT showed a fractured vertebra, and before the neurologist moved forward with treating the fracture, she wanted to make sure nothing was going on internally to weaken his bones.
After lots of testing, elevated protein was found in blood and urine. I was told his m-spike was 2. He was sent to an pathologist who began running the tests for multiple myeloma. This was early this week and the results have begun coming in.
From my unprofessional and uneducated perspective, I am beginning to feel more optimistic with each result because they do not seem very far off the norms. I live 4 states away from my parents so not being there to hear the doctor or ask questions is driving me absolutely nuts. Do my father's results indicate his multiple myeloma is severe, or not so severe?
M Spike - 2
Albumin - 3.6
Beta-2 microglobulin - 1.44 mg/L (0.97-2.43) - in range
lgG - 1743 mg/dL (723-1685) - slightly high
lgA - 165 mg/dL (69-382) - in range
lgM - 165 mg/dL (63-272) - in range
Free Kappa Light Chains - 2.29 mg/dL (0.33-1.94) - high
Free Lambda Light Chains - 1.43 mg/dL (0.57-2.63) - in range
Kappa/Lambda Fluid LC Ratio - 1.60 (0.26-1.65) - in range
I don't know the results but my mom said blood counts are normal. Skeletal survey results came in today and everything was clear (with the exception of the neck). No other physical complaints (weight loss, fatigue, etc.). I believe the last thing we are waiting on is the bone marrow biopsy that is supposed be in on Monday.
Thanks again.
Anthony
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Re: How severe is my father's multiple myeloma?
Hi Anthony,
Given your dad's IgG value, I'm assuming the M-spike of "2" is expressed in g/L and not g/dL?
Barring the detection of any lytic lesions due to multiple myeloma in your dad's neck, or a high bone marrow plasma cell percentage coming back from his bone marrow results, and assuming that his calcium, hemoglobin and creatinine levels are all normal, this sounds more like a case of MGUS, not multiple myeloma.
The risk of MGUS transforming into multiple myeloma is only about 1-2% per year. One does not treat MGUS and the majority of MGUS patients are none the worse for having the condition.
But you really need your dad's doctor to verify all this.
Given your dad's IgG value, I'm assuming the M-spike of "2" is expressed in g/L and not g/dL?
Barring the detection of any lytic lesions due to multiple myeloma in your dad's neck, or a high bone marrow plasma cell percentage coming back from his bone marrow results, and assuming that his calcium, hemoglobin and creatinine levels are all normal, this sounds more like a case of MGUS, not multiple myeloma.
The risk of MGUS transforming into multiple myeloma is only about 1-2% per year. One does not treat MGUS and the majority of MGUS patients are none the worse for having the condition.
But you really need your dad's doctor to verify all this.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How severe is my father's multiple myeloma?
Thanks for the reply!
Yes, I believe the M-spike of 2 is expressed in g/L - I was told that value over the phone and was sent a picture of the other ones.
His calcium, hemoglobin, and creatinine levels all look normal. Would it be rare to have a high bone marrow plasma cell percentage with these mostly all normal lab values and a clear skeletal survey? I have tried to find research on what these numbers typically look like at the time of diagnosis but haven't had much success.
Calcium - 9.5 mg/dL (8.5-10.2)
Hemoglobin - 14.6 g/dL (13.5-17.5)
Creatinine - 0.8 mg/dL (0.6-1.2)
Yes, I believe the M-spike of 2 is expressed in g/L - I was told that value over the phone and was sent a picture of the other ones.
His calcium, hemoglobin, and creatinine levels all look normal. Would it be rare to have a high bone marrow plasma cell percentage with these mostly all normal lab values and a clear skeletal survey? I have tried to find research on what these numbers typically look like at the time of diagnosis but haven't had much success.
Calcium - 9.5 mg/dL (8.5-10.2)
Hemoglobin - 14.6 g/dL (13.5-17.5)
Creatinine - 0.8 mg/dL (0.6-1.2)
Re: How severe is my father's multiple myeloma?
AD1988,
If your father was diagnosed with multiple myeloma based upon the "CRAB requirements", it would appear it was based upon bone involvement – most likely from an active myeloma lesion. It is hard to answer 'how severe' his myeloma is, because it would first be necessary to determine if he is high- or low-risk. All specialized myeloma centers will determine that risk by analyzing his bone marrow sample among other tests.
I'm not a medical professional, but I would personally be inclined to stabilize or fix the vertebra in the neck ASAP. Myeloma treatment decisions generally can wait weeks if necessary.
I will say it appears he was diagnosed at a very early stage which, if not beneficial to prognosis, it is definitely beneficial to quality of life issues. I think he is very fortunate in that regard.
My compressed vertebrae were successfully treated with kyphoplasty and vertebroplasty – different procedures at different hospitals, but very similar procedures.
If your father was diagnosed with multiple myeloma based upon the "CRAB requirements", it would appear it was based upon bone involvement – most likely from an active myeloma lesion. It is hard to answer 'how severe' his myeloma is, because it would first be necessary to determine if he is high- or low-risk. All specialized myeloma centers will determine that risk by analyzing his bone marrow sample among other tests.
I'm not a medical professional, but I would personally be inclined to stabilize or fix the vertebra in the neck ASAP. Myeloma treatment decisions generally can wait weeks if necessary.
I will say it appears he was diagnosed at a very early stage which, if not beneficial to prognosis, it is definitely beneficial to quality of life issues. I think he is very fortunate in that regard.
My compressed vertebrae were successfully treated with kyphoplasty and vertebroplasty – different procedures at different hospitals, but very similar procedures.
-
blueblood - Name: Craig
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: March 2014
- Age at diagnosis: 54
Re: How severe is my father's multiple myeloma?
Regarding bone marrow plasma cell percentages (BMPCs), it's likely that your dad is going to come up with a fairly low BMPC (below 10%) that is consistent with a diagnosis of MGUS - especially given his other numbers and imaging results. This is good. Note that a person without myeloma should have a BMPC between 0 and 5%.
But there are versions of myeloma where the disease doesn't express itself or only partially expresses itself in the blood numbers and instead manifests itself primarily in the bone marrow. These less-common conditions are known as non-secretory and oligosecretory myeloma, respectively. So, you won't really know where things stand until you get the bone marrow test results back.
But there are versions of myeloma where the disease doesn't express itself or only partially expresses itself in the blood numbers and instead manifests itself primarily in the bone marrow. These less-common conditions are known as non-secretory and oligosecretory myeloma, respectively. So, you won't really know where things stand until you get the bone marrow test results back.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How severe is my father's multiple myeloma?
Hi Anthony,
Just wondering how things are going with your dad and his diagnosis?
Tony
Just wondering how things are going with your dad and his diagnosis?
Tony
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Tony Y - Name: Tony Y
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: April 2017
- Age at diagnosis: 49
6 posts
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