I've posted below my lab test results prior to starting treatment with cyclophosphamide, Velcade, and dexamethasone (CyBorD) (on November 17, 2015) and after 8 treatments (on January 11, 2016). I've only posted results that were abnormal on either date. I haven't posted results on creatinine, bilirubin, white blood cells, etc., which were normal on both dates. Please keep in mind that these are Canadian numbers.
To me, it looks like the treatment is working well. I believe my M-spike is the 55 g/L number (5.5 in US calculations) which is now down to 8.0 or 0.8 in US calculations. How low do they typically want to see this number before the autologous stem cell transplant (ASCT)? I'm hoping to get away with only 12 treatments prior to my ASCT, but realize I might need the full 16.
Please let me know if anyone sees anything puzzling or of concern in these results which I should discuss with my doctor.
Thank you,
Karen
Protein (Normal range) 62-82 g/L
Protein (Nov 17 2015) 108 g/L
Protein (Jan 11 2016) 71 g/L
Albumin (Normal range) 36-50 g/L
Albumin (Nov 17 2015) 33 g/L
Albumin (Jan 11 2016) 44 g/L
Total Gamma (Normal range) 6-15 g/L
Total Gamma (Nov 17 2015) 57 g/L
Total Gamma (Jan 11 2016) 10 g/L
Other Peaks (Nov 17 2015):
Extra Peak present in gamma region of 55 g/L
Other Peaks (Jan 11 2016):
Extra Peak present in gamma region of 8 g/L
Serum IEP/IFE (Nov 17 2015):
IFE revealed the presence of IGG type
kappa monoclonal protein
Serum IEP/IFE (Jan 11 2016):
The homogenous band in the gamma region of
the SPE has been characterized previously;
IFE is not indicated
IgM immunoglobulin (Normal range) 0.40-2.30 g/L
IgM immunoglobulin (Nov17 2015) 0.23 g/L
IgM immunoglobulin (Jan 11 2016) 0.26 g/L
IgG immunoglobulin (Normal range) 7.00-15.00 g/L
IgG immunoglobulin (Nov 17 2015) 65.20 g/L
IgG immunoglobulin (Jan 11 2016) 13.20 g/L
IgA immunoglobulin (Normal range) 0.70-4.00 g/L
IgA immunoglobulin (Nov 17 2015) 0.63 g/L
IgA immunoglobulin (Jan 11 2016) 0.34 g/L
Free Kappa (Normal range) 3.30-19.40 mg/L
Free Kappa (Nov 17 2015) 1817.00 mg/L
Free Kappa (Jan 11 2016) 8.60 mg/L
Free Lambda (Normal range) 5.71-26.30 mg/L
Free Lambda (Nov 17 2015) 1.46 mg/L
Free Lambda (Jan 11 2016) 1.00 mg/L
Free Kappa/Lambda ratio (Normal range) 0.26-1.65
Free Kappa/Lambda ratio (Nov 17 2015) 1244.52
Free Kappa/Lambda ratio (Jan 11 2016) 8.60
Hemoglobin (Normal Range) 115-165 g/L
Hemoglobin (Nov 17 2015) 91 g/L
Hemoglobin (Jan 11 2016) 121 g/L
Calcium (Normal Range) 2.10-2.60 mmol/L
Calcium (Nov 17 2015) 2.86 mmol/L
Calcium (Jan 11 2016) 2.18 mmol/L
Forums
9 posts
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KarenaD - Name: Karen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: November 4, 2015
- Age at diagnosis: 54
Re: My lab tests results - anything I should question?
Hi Karena,
The combo of your low lambda, normal kappa, and high free light chain (FLC) ratio could suggest bone marrow suppression (myelosuppression), which can in turn can result in anemia, thrombocytopenia and/or neutropenia. But you say your CBC numbers are all good, which is welcome news and would suggest you aren't dealing with myelosuppression. I therefore might suggest that you ask your doc about your low lambda number and just what it means – especially since you had it before and after you started treatment.
I know some docs want to push for as deep a treatment response as possible prior to ASCT, and there have been some arguments for taking this approach. But it seems from my readings that most docs will back off on this goal if the treatment gets to be too toxic prior to the ASCT. Are you holding up well with the CyBorD treatments, or are they just a hassle and you are simply tired of dealing with them?
The combo of your low lambda, normal kappa, and high free light chain (FLC) ratio could suggest bone marrow suppression (myelosuppression), which can in turn can result in anemia, thrombocytopenia and/or neutropenia. But you say your CBC numbers are all good, which is welcome news and would suggest you aren't dealing with myelosuppression. I therefore might suggest that you ask your doc about your low lambda number and just what it means – especially since you had it before and after you started treatment.
I know some docs want to push for as deep a treatment response as possible prior to ASCT, and there have been some arguments for taking this approach. But it seems from my readings that most docs will back off on this goal if the treatment gets to be too toxic prior to the ASCT. Are you holding up well with the CyBorD treatments, or are they just a hassle and you are simply tired of dealing with them?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: My lab tests results - anything I should question?
Thank you for your feedback, Multibilly. I, too, wondered about that low lambda number, and will ask my doctor about it at my next appointment on Feb 8.
I'm tolerating the CyBorD quite well, and have fairly minimal physical side effects from it. It is more the inconvenience of traveling to and from the cancer center each week and dealing with the psychological effects of undergoing chemotherapy which are wearing on me. I've also had to lean on my ex husband for additional assistance with childcare as I go through this process ... and I guess I'm just impatient to get through the chemotherapy and ASCT and back to some semblance of a normal life.
Karen
I'm tolerating the CyBorD quite well, and have fairly minimal physical side effects from it. It is more the inconvenience of traveling to and from the cancer center each week and dealing with the psychological effects of undergoing chemotherapy which are wearing on me. I've also had to lean on my ex husband for additional assistance with childcare as I go through this process ... and I guess I'm just impatient to get through the chemotherapy and ASCT and back to some semblance of a normal life.
Karen
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KarenaD - Name: Karen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: November 4, 2015
- Age at diagnosis: 54
Re: My lab tests results - anything I should question?
Karena,
Any chance they can give you your Velcade portion of CyBorD at Guelph Gen instead of having to travel to K-Town for it ?
Any chance they can give you your Velcade portion of CyBorD at Guelph Gen instead of having to travel to K-Town for it ?
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: My lab tests results - anything I should question?
Hi Little Monkey,
I need to travel to K-Town for the blood tests that are required prior to every Velcade treatment so no way to avoid the travel.
Karen
I need to travel to K-Town for the blood tests that are required prior to every Velcade treatment so no way to avoid the travel.
Karen
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KarenaD - Name: Karen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: November 4, 2015
- Age at diagnosis: 54
Re: My lab tests results - anything I should question?
Looks like you are having an excellent response to treatment. Congrats!
RT
RT
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RadiantTiger - Name: Radiant Tiger
- Who do you know with myeloma?: Myself, my deceased uncle
- When were you/they diagnosed?: Feb 2015
- Age at diagnosis: 54
Re: My lab tests results - anything I should question?
Hi Karena D,
My wife recently completed the same CyBorD and monthly pamidronate in Toronto prior to her first autologous stem cell transplant (ASCT). Worked really well as her counts went down significantly. Seems yours have too. Will soon find out when her 2nd ASCT will occur and what her blood work will show. Where is your ASCT being done?
My wife recently completed the same CyBorD and monthly pamidronate in Toronto prior to her first autologous stem cell transplant (ASCT). Worked really well as her counts went down significantly. Seems yours have too. Will soon find out when her 2nd ASCT will occur and what her blood work will show. Where is your ASCT being done?
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SK1 - Name: SK
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: June 2015
- Age at diagnosis: 62
Re: My lab tests results - anything I should question?
Hi SK1 and RT,
I apologize for not responding earlier; I'm afraid I just saw your messages now.
RT: Thanks for your note of encouragement.
SK1: My ASCT will be done in Hamilton. May I ask why your wife is undergoing a second (tandem) ASCT?
Karen
I apologize for not responding earlier; I'm afraid I just saw your messages now.
RT: Thanks for your note of encouragement.
SK1: My ASCT will be done in Hamilton. May I ask why your wife is undergoing a second (tandem) ASCT?
Karen
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KarenaD - Name: Karen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: November 4, 2015
- Age at diagnosis: 54
Re: My lab tests results - anything I should question?
Well, at the end of 4 cycles of CyBorD, my M-spike is down to 5 g/L (0.5 g/dL) from a high of 55 g/L (5.5 g/dL) at diagnosis on November 4, 2015. All of my other numbers are back to normal and there are now "less than 1% plasma cells detected by flow cytometry" on a recent bone marrow biopsy.
My doctors are very pleased with my response to the therapy, and I'll begin preparation for my autologous stem cell transplant (ASCT) next week with the insertion of a port-catheter.
Thank you to everyone who posts here. Hearing your stories and reading of your experiences has helped me a great deal in making my decision to proceed with the ASCT.
Karen
My doctors are very pleased with my response to the therapy, and I'll begin preparation for my autologous stem cell transplant (ASCT) next week with the insertion of a port-catheter.
Thank you to everyone who posts here. Hearing your stories and reading of your experiences has helped me a great deal in making my decision to proceed with the ASCT.
Karen
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KarenaD - Name: Karen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: November 4, 2015
- Age at diagnosis: 54
9 posts
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