Hi, all. I am still awaiting my appointment with the hematology oncologist.
I received my SPEP with immunoxation results. No abnormal band was detected; however, my albumin was flagged as low, as well as hypogammaglobunemia noted on the results.
I have done much reading of research articles on these results, and have found that about 10% of myeloma patients have these results, and that the myeloma is subsequently found on a light chain blood test. However, I have also read that lymphoma is also typical of these patterns.
All of the testing to date started due to an MRI of my spine, in which the radiologist (25 years of experience and Chief of her Department) believed she saw some bone marrow infiltration, and suggested I be tested for "Myeloma and other hematologic malignancies" (see my posting here describing more about the background of my case).
Thus far, no lab work has come back normal (rouleaux in the red blood cells, borderline anemia, low albumin and hypogammaglobulinemia).
Any thoughts? Today is one month since the MRI came back, and I am worn out with the waiting.
Thanks for any thoughts or hypotheses.
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9 posts
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Re: No abnormal bands on SPEP & IFE - any new ideas?
Hi psychprof23,
Well, I'd say it's a good sign that the SPEP and immunofixation came back negative, although I can appreciate the frustration in not knowing more definitively what's going on.
I'll have to think about this some more before sharing any opinions. But I do have one question: Have you had free light chain testing done yet using a blood sample?
Well, I'd say it's a good sign that the SPEP and immunofixation came back negative, although I can appreciate the frustration in not knowing more definitively what's going on.
I'll have to think about this some more before sharing any opinions. But I do have one question: Have you had free light chain testing done yet using a blood sample?
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JimNY
Re: No abnormal bands on SPEP & IFE - any new ideas?
No, not yet. I am hoping that the hematology oncologist will order a free light chain test next week when I see him. Thank you for any hypotheses/ideas you might come up with. I am reading that low albumin and low IgG are common in persons with light chain myeloma, and other blood malignancies.
Thank you much.
Mara
Thank you much.
Mara
Re: No abnormal bands on SPEP & IFE - any new ideas?
Yes, the serum free light chain results will be very important.
You mentioned in a previous posting that you have low, but not below normal, hemoglobin levels. Could you put up your latest hemoglobin, creatinine, and blood calcium levels, if you happen to have them available?
Also, it appears that you've had your immunoglobulin levels tested. What were the actual IgG, IgA, and IgM levels?
If you could include units and the normal ranges that were included with the results in your labs, that would be helpful. The normal ranges sometimes vary from lab to lab, and having them present also helps those of us who haven't yet memorized what they usually are.
You mentioned in a previous posting that you have low, but not below normal, hemoglobin levels. Could you put up your latest hemoglobin, creatinine, and blood calcium levels, if you happen to have them available?
Also, it appears that you've had your immunoglobulin levels tested. What were the actual IgG, IgA, and IgM levels?
If you could include units and the normal ranges that were included with the results in your labs, that would be helpful. The normal ranges sometimes vary from lab to lab, and having them present also helps those of us who haven't yet memorized what they usually are.
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JimNY
Re: No abnormal bands on SPEP & IFE - any new ideas?
Hello, and thank you for replying.
My RBC count is 4.21 - reference 4.21-6.3
Hemoglobin is 13 - reference 12-15.9
Creatinine - 0.62 - reference 0.60-1.20
The last two labs were completed over 9 months ago. The RBC and hemoglobin are from last month.
Calcium over 6 months old - 9.3 with 10 being the highest reading for normal range.
Albumin has dropped from 4.5 to 3.5 over past six months.
My RBC count is 4.21 - reference 4.21-6.3
Hemoglobin is 13 - reference 12-15.9
Creatinine - 0.62 - reference 0.60-1.20
The last two labs were completed over 9 months ago. The RBC and hemoglobin are from last month.
Calcium over 6 months old - 9.3 with 10 being the highest reading for normal range.
Albumin has dropped from 4.5 to 3.5 over past six months.
Re: No abnormal bands on SPEP & IFE - any new ideas?
Those are helpful.
Did you ever have your immunoglobulin levels tested (IgG, IgA, IgM, etc.)? It can be useful to see if any of their levels are elevated above the normal range, or suppressed.
Did you ever have your immunoglobulin levels tested (IgG, IgA, IgM, etc.)? It can be useful to see if any of their levels are elevated above the normal range, or suppressed.
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JimNY
Re: No abnormal bands on SPEP & IFE - any new ideas?
The SPEP with Immunofixation showed my albumin is borderline at 3.5 now, my IgG is flagged as low, and hypogammaglobulinemia is diagnosed in the results section. My Beta 2 is at 1.7, which I believe is the high end cut off for normal by this lab.
Re: No abnormal bands on SPEP & IFE - any new ideas?
Hello Mara,
Interesting question, thank you for submitting it to The Beacon.
I think that the best thing for now is to have a hematologist-oncologist review all of this and give you their expert opinion. The finding of an abnormal marrow signal on MRI in otherwise asymptomatic patients is not rare and could represent many different etiologies (both benign and malignant).
If the abnormal MRI signal is confined to one area / location only, then a biopsy of that region may be needed. If the abnormal MRI signal is diffuse and spread throughout your bones, then a bone marrow biopsy of your iliac crest may be valuable.
I hope that your evaluation turns out to be benign.
Good luck with all of this!
Interesting question, thank you for submitting it to The Beacon.
I think that the best thing for now is to have a hematologist-oncologist review all of this and give you their expert opinion. The finding of an abnormal marrow signal on MRI in otherwise asymptomatic patients is not rare and could represent many different etiologies (both benign and malignant).
If the abnormal MRI signal is confined to one area / location only, then a biopsy of that region may be needed. If the abnormal MRI signal is diffuse and spread throughout your bones, then a bone marrow biopsy of your iliac crest may be valuable.
I hope that your evaluation turns out to be benign.
Good luck with all of this!
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
9 posts
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