Hi everyone,
My husband's serum protein electrophoresis (SPEP) and immunofixation electophoresis (IFE) have shown no M-spike for several months now. Wonderful! BUT, this month's SPEP/IFE had a comment that there is evidence of hemolysis. I think this means he has hemolytic anemia.
Does anyone have any experience with this? Is it relatively benign? Is it something that requires treatment and how is it treated? His red blood cells (RBC) are in the normal range.
Thank you all in advance for sharing your experiences and knowledge.
Laurie
Forums
9 posts
• Page 1 of 1
-
lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: No M-spike but evidence of hemolysis
Was your husband's kappa / lambda ratio within the normal range?
-
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: No M-spike but evidence of hemolysis
Yes, kappa and lambda free light chains are normal; ratio is normal. His uninvolved immunoglobulins are low (IgA and IgM). He has had IVIG monthly for a few months now, so his IgG (he has IgG kappa myeloma) is in the normal range, but it also had been low previously.
-
lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: No M-spike but evidence of hemolysis
Hi Iwemn,
My first symptom of having something wrong with me last February was hemolytic anemia. I wound up in the hospital with a blood transfusion and then high dose prednisone. Then we tried a few weeks treatment with Rituxan (rituximab). The prednisone kept it under control, but I wasn't ever able to completely wean down to a low level of prednisone. Then they diagnosed the myeloma. I started several treatments with cyclosphosphamide, Velcade, and dexamethasone (CyBorD) in preparation for a stem cell transplant, and the hemolysis as stopped.
I've read that cyclophosphamide is one of the treatments for autoimmune hemolytic anemia. In the beginning, the diagnosis was autoimmune hemolytic anemia (not something particularly associated with myeloma). But, possibly the myeloma was wreaking havoc with my immune system and sort of derailed things, so may have been driving the anemia? I'm hoping it is gone now, and that my stem cell transplant (autologous) will reset that issue.
Definitely something that would bear investigating by your oncologist, so that it doesn't get out of hand. My hemoglobin went down to 7 and I needed a ride in an ambulance.
My first symptom of having something wrong with me last February was hemolytic anemia. I wound up in the hospital with a blood transfusion and then high dose prednisone. Then we tried a few weeks treatment with Rituxan (rituximab). The prednisone kept it under control, but I wasn't ever able to completely wean down to a low level of prednisone. Then they diagnosed the myeloma. I started several treatments with cyclosphosphamide, Velcade, and dexamethasone (CyBorD) in preparation for a stem cell transplant, and the hemolysis as stopped.
I've read that cyclophosphamide is one of the treatments for autoimmune hemolytic anemia. In the beginning, the diagnosis was autoimmune hemolytic anemia (not something particularly associated with myeloma). But, possibly the myeloma was wreaking havoc with my immune system and sort of derailed things, so may have been driving the anemia? I'm hoping it is gone now, and that my stem cell transplant (autologous) will reset that issue.
Definitely something that would bear investigating by your oncologist, so that it doesn't get out of hand. My hemoglobin went down to 7 and I needed a ride in an ambulance.
Re: No M-spike but evidence of hemolysis
Debbie,
Thank you. He hasn't had an M-spike for several months now, and hasn't had any treatment either (other than IVIG for hypogammaglobulinemia and Zometa).
Interesting, his CBC (including his red blood cells) was all normal. Did you have low red blood cell count with this?
Laurie
Thank you. He hasn't had an M-spike for several months now, and hasn't had any treatment either (other than IVIG for hypogammaglobulinemia and Zometa).
Interesting, his CBC (including his red blood cells) was all normal. Did you have low red blood cell count with this?
Laurie
-
lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: No M-spike but evidence of hemolysis
Laurie,
I am a medical lab tech and sometimes a comment like that is attached to a sample that shows hemolysis of the sample itself, which can falsely alter lab results themselves due to sample condition. It effects some test and not others. I am not sure about SPEP, as we do not do those in the lab that I work. Just a thought ... it would depend on how the comment was worded, where on the result it was noted, etc., to be able to tell if it was an actual part of the report or an attached comment concerning sample condition.
I am a medical lab tech and sometimes a comment like that is attached to a sample that shows hemolysis of the sample itself, which can falsely alter lab results themselves due to sample condition. It effects some test and not others. I am not sure about SPEP, as we do not do those in the lab that I work. Just a thought ... it would depend on how the comment was worded, where on the result it was noted, etc., to be able to tell if it was an actual part of the report or an attached comment concerning sample condition.
-
dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: No M-spike but evidence of hemolysis
Hi Laurie,
Yes, I did have low red blood cell count. I had been feeling excessive fatigue and it showed up on my annual physical. 2 weeks later I was in the hospital, and then 3 weeks later I was diagnosed with myeloma.
Yes, I did have low red blood cell count. I had been feeling excessive fatigue and it showed up on my annual physical. 2 weeks later I was in the hospital, and then 3 weeks later I was diagnosed with myeloma.
Re: No M-spike but evidence of hemolysis
Thank you all. And dogmom, you are correct. The doctor says it just means the specimen was shaken and broke red blood cells.
Thank you all for responding!
Laurie
Thank you all for responding!
Laurie
-
lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: No M-spike but evidence of hemolysis
I am so glad that it was a sample comment only.
-
dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
9 posts
• Page 1 of 1