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No M-Spike in Urine - Good sign?
My husband has just completed Cycle 4 of his treatment. He is doing the prep work for a SCT. His last results (after Cycle 3) showed Kappa Light Chains of 24, with a ratio of 2.4. He just had a bone marrow biopsy this week (waiting on the results). They called and said the urine test had no M-Spike, no sign of light or heavy chains. Is this a good indicator? I am not sure about how urine plays into this disease. HELP!
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LadyLib - Name: LadyLib
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: July 2013
- Age at diagnosis: 42
Re: No M-Spike in Urine - Good sign?
"M-Spike" really is a term that refers to the level of monoclonal immunoglobulin (heavy chains) protein levels in one's BLOOD serum, not one's urine. Heavy chains don't show up in one's urine as they are too big to pass through one's kidneys. However, Freelite chains are smaller and do show up in the urine and this is what one looks for in a urine test know as a UPEP.
The M-Spike is measured by a blood serum test called an SPEP. Did they tell you about the SPEP too or only the urine (UPEP) test? Also, remember that depending on what kind of myeloma he has, he may have had no M-Spike to begin with. So, you need to go back and look at the numbers before he started treatment.
Don't get me wrong...having no Freelite chains in the urine is a great thing and you might have just jumbled the M-Spike serum number in with the urine test numbers. And the normal range for Kappa FLC (in the blood) is 3.3 to 19.4 mg/L, so he is only just a tad high on his Kappa FLC. The normal K/L ratio is 0.26 to 1.65. Since your Kappa FLC is a tad high, his ratio is also only just a tad high.
Understanding what all this means improvement-wise depends on what the numbers were before the treatment began. Do you know those?
Hope this helps. Best of luck.
The M-Spike is measured by a blood serum test called an SPEP. Did they tell you about the SPEP too or only the urine (UPEP) test? Also, remember that depending on what kind of myeloma he has, he may have had no M-Spike to begin with. So, you need to go back and look at the numbers before he started treatment.
Don't get me wrong...having no Freelite chains in the urine is a great thing and you might have just jumbled the M-Spike serum number in with the urine test numbers. And the normal range for Kappa FLC (in the blood) is 3.3 to 19.4 mg/L, so he is only just a tad high on his Kappa FLC. The normal K/L ratio is 0.26 to 1.65. Since your Kappa FLC is a tad high, his ratio is also only just a tad high.
Understanding what all this means improvement-wise depends on what the numbers were before the treatment began. Do you know those?
Hope this helps. Best of luck.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: No M-Spike in Urine - Good sign?
Great information. I am not sure what his numbers were before. I just remember them making a statement saying - "you're dumping blood and protein through your urine" early on. He meets with his doctor tomorrow, so we will have more information then hopefully.
Because his kidneys were so bad off at diagnosis, I would think his urine was in bad shape as well. However, not sure.
Because his kidneys were so bad off at diagnosis, I would think his urine was in bad shape as well. However, not sure.
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LadyLib - Name: LadyLib
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: July 2013
- Age at diagnosis: 42
Re: No M-Spike in Urine - Good sign?
To put it bluntly, it's very good news.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: No M-Spike in Urine - Good sign?
Thanks everyone for helping me understand this better.
I cannot locate the urine results he started with as stated before. However, I do remember them saying his urine was dumping protein and blood which caused them to go further with tests, including the BMB at diagnosis. So, I am assuming there was something there.
His Kappa Free Light Chain number at diagnosis was 518, its now 24 (after 3 cycles)
His bone marrow/blood involvement was 50%
His kidney was/is impaired. He had a creatinine level of 6.6, it is now 3.8 (still very high)
We are awaiting the other test still...I will keep you posted.
I am praying that the urine is a good sign.
I cannot locate the urine results he started with as stated before. However, I do remember them saying his urine was dumping protein and blood which caused them to go further with tests, including the BMB at diagnosis. So, I am assuming there was something there.
His Kappa Free Light Chain number at diagnosis was 518, its now 24 (after 3 cycles)
His bone marrow/blood involvement was 50%
His kidney was/is impaired. He had a creatinine level of 6.6, it is now 3.8 (still very high)
We are awaiting the other test still...I will keep you posted.
I am praying that the urine is a good sign.
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LadyLib - Name: LadyLib
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: July 2013
- Age at diagnosis: 42
Re: No M-Spike in Urine - Good sign?
Believe me it takes time, but the important thing is his stats are moving in the right direction.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: No M-Spike in Urine - Good sign?
Dear LadyLib,
This is a terrific result for 4 cycles! It sounds like your husband has free kappa light chain multiple myeloma, which is why there was kidney failure at initial diagnosis. It would appear that your husband is in a "very good partial response" -- meaning a >90% drop in the monoclonal free kappa light chain levels -- and will hopefully be in a complete remission soon. Hopefully, the kidney function will continue to improve now that the disease is on the run.
Keep up the great work!
Pete V.
This is a terrific result for 4 cycles! It sounds like your husband has free kappa light chain multiple myeloma, which is why there was kidney failure at initial diagnosis. It would appear that your husband is in a "very good partial response" -- meaning a >90% drop in the monoclonal free kappa light chain levels -- and will hopefully be in a complete remission soon. Hopefully, the kidney function will continue to improve now that the disease is on the run.
Keep up the great work!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: No M-Spike in Urine - Good sign?
The Bone Marrow biopsy was confirmed today, the cells were less than 2% (from 50%) in 4 cycles. So, things are going well and he will begin the transplant process shortly.
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LadyLib - Name: LadyLib
- Who do you know with myeloma?: Spouse
- When were you/they diagnosed?: July 2013
- Age at diagnosis: 42
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