[Sandi G]

Sandi G, Ipswich, Australia

by Sandi G on Wed Mar 21, 2018 11:00 pm

Hi,

I was diagnosed June 2017, at the age of 59, with smoldering myeloma after a period of un­in­tentional weight loss (8 kg, or 17.5 pounds, in 3 months), severe bone pain (spine and ribs), and extreme tiredness.

I had a 5-year history of consistent lymphocytosis which had gone unnoticed until this time, and was previously diagnosed with osteoporosis (age 51) in 2009 and mild fatty liver (non-alcohol) around the same time, which is now moderate.

Tests in March 2017 revealed IgG lambda MGUS with a paraprotein of 18/g/L (1.8 g/dL). IgM was low at 0.25 g/l (normal range on test results states 0.48 - 3.1). Cumulative full blood count showed no major issues, with notes stating mild lymphocytosis and mild thrombocytosis. E/LFT (MASTER) showed no major issues. Everything within normal range except for Urate (0.49 mmol/L), and Glob (41 g/L).

Paraprotein was monitored monthly for 3 months by GP, then I was referred to haematologist-oncologist specialising in myeloma, who referred me for bone marrow testing, then diagnosed smoldering multiple myeloma. Full skeletal MRI showed no bone lesions.

Weight loss, fatigue, and bone paid subsided of its own accord around August 17. Oncologist said my weight loss was not relevant to the smoldering multiple myeloma, and referred me back to my GP to follow up with a colonoscopy, which showed very health bowel.

Ongoing tests show slight increase in IgG to 22.2 (stable for 3 consecutive tests). B2M in normal range at 2.22 mg/L; kappa-lambda ratio 0.52; albumin level has steadily decreased from 41 g/L in first test to 34 g/l in most recent test. Currently experiencing another period of unintended weight loss (10 kg in 3 months) and fatigue.

[Cheryl G]

Re: Sandi G, Ipswich, Australia

by Cheryl G on Fri Mar 23, 2018 12:36 pm

Welcome to the forum, Sandi. I think you'll find it an excellent source of information and support.

In addition to tracking your M-spike (paraprotein) level, you also may want to consider tracking your hemoglobin and calcium levels. Decreases in your hemoglobin level, and increases in your calcium level, could indicate that your disease is becoming more extensive.

Also, are your doctors tracking your serum free light chain levels? The serum free light chain test reports your kappa and lambda free light chain levels, and it also will report either your kappa-lambda or lambda-kappa ratio (or both). In your case, the lambda-kappa ratio is more useful, since your myeloma is the IgG lambda isotype.

Best wishes,
Cheryl

[Sandi G]

Re: Sandi G, Ipswich, Australia

by Sandi G on Fri Mar 23, 2018 8:34 pm

Hi Cheryl.

Thanks for your response.

Free light chains are being monitored. Original lab results were

Kappa 14 mg/L
Lambda 10 mg/L
Kappa-lambda ratio 1.4.

Last lab results are

Kappa remains the same
Lambda has risen to 27mg /L.
Kappa-lambda ratio 0.52 (lab result).
Lambda-kappa ratio would be 1.9 (my calculation).

Can only see calcium result in original lab results; was within normal range.