[country girl]

Plasmapheresis & reliability of myeloma testing?

by country girl on Sun Mar 15, 2015 10:28 pm

Hello group. Sorry for the long post. I recently had an MRI with contrast because of a hugging sensation (I really call it a severe cramp) around my rib cage under my breast area. The MRI came back with generalized heterogeneity of the marrow signal as well as a focal T1, T2 hypo-intense lesion within the T5 vertebral body.

I know these findings can be benign or nothing to do with multiple myeloma. My question is: What kind of tests can I expect?

My concern with the blood testing is because I have myasthenia gravis and have plasma­pheresis every 3 weeks and am also on the immuno­sup­pressant tacrolimus (Prograf) and also rituximab (Rituxan, Mabthera).

Do you know if these drugs can skew the blood test results – especially plasmapheresis, since it removes plasma and replaces it with synthesized albumin? I know many of the blood tests are plasma based. (?)

Thanks

[country girl]

Re: Plasmapheresis & reliability of myeloma testing?

by country girl on Sun Mar 15, 2015 10:47 pm

I should add they are testing for multiple myeloma. I have had anemia for a couple of years. Also a thymoma [tumor of the thymus], resected and adjunct proton radiation.

[Multibilly]

Re: Plasmapheresis & reliability of myeloma testing?

by Multibilly on Mon Mar 16, 2015 8:39 am

Hi Country Girl,

I am not at all qualified to answer whether your current treatments and conditions would impact these tests, but I could see how you might be concerned that it would throw off the tests. I would think that these tests (specifically the IFE, SPEP and Freelite assay, and maybe the 24 hour UPEP) would still tell you if you have some amount of monoclonal protein in your blood or urine, which is a hallmark of nearly all versions of multiple myeloma.

Best of luck on your testing and please let us know how things turn out.

[country girl]

Re: Plasmapheresis & reliability of myeloma testing?

by country girl on Mon Mar 16, 2015 9:53 am

Thank you for your response and I'll let you know how things turn out.

[Dr. Jonathan Kaufman]

Re: Plasmapheresis & reliability of myeloma testing?

by Dr. Jonathan Kaufman on Thu Mar 26, 2015 10:43 pm

The first thing I would do if there is concern about myeloma is to perform the standard lab tests:
SPEP with immunofixation, UPEP with immunofixation and serum free light chain. If all of those are "OK" then you can feel confident that this abnormal MRI is unlikely myeloma. The plasma­phe­re­sis can impact these tests, but it won't completely make the tests normal.

Best wishes,

Jlk