I agree with TerryH's assessment of the situation. If you are interested, it would be possible for you to see either myself or my colleague Dr. Usmani at Levine Cancer Institute in Charlotte. You can call my office at 980-442-5219. If I am not there, leave a voicemail where I can reach you. The gene...

Dear NotSamantha, You may have MGUS based on what you are reporting. If you do, the level of abnormal plasma cells is so low that the M-spike (abnormal antibody produced by the clonal plasma cells) is barely detectable. The SPEP is not as sensitive as the immunofixation test at picking up very low l...

Dear LisaE, Even taking into account some differences between the 2 images technically, the improvement is remarkable. We, too, have had patients who have responded well to therapy in whom the "holes," or lytic bone lesions, become less conspicuous over time (although they are typically st...

Dear BehaviorQueen, Decisions regarding transplant are complicated. At the present time, high-dose melphalan chemotherapy given as part of an autologous stem cell transplant, either immediately after initial induction therapy or later in the course of the disease, uniformly leads to more durable rem...

Dear Oynk, Again, Multibilly is right. I think I am going to hire him to work with me if he keeps it up! We need to be careful about the designation of smoldering myeloma. Immunoparesis (suppression of the uninvolved immunoglobulin) is a risk factor for progression of smoldering myeloma to multiple ...

Dear Susan, Multibilly, in usual fashion, is spot on. Your serum free light chain ratio meets criteria for a myeloma-defining event. And, yes, Sloan is top notch and their physicians well familiar with the new criteria. It may be that your light chain measures in 2013 were very similar to where they...

Dear Twinkle126, Recently updated International Myeloma Working Group criteria for starting treatment in patients with multiple myeloma include the presence of a serum free light chain ratio of 100 or more, recognizing that even in the absence of symptoms, patients who meet this criterion are at hig...

Dear Coach, This is a great question. This may seem like a cop out, but we do need additional prospective data to get a more quantifiable answer to this question. If Revlimid has maintained disease control for 2 years in the maintenance setting, this would predict that Revlimid therapy upon re-chall...

Dear all, The duration of Revlimid maintenance remains a hotly debated topic. I think all would agree that at least 2 years of maintenance Revlimid is associated with longer durations of remission for patients. In the post-autologous stem cell transplant setting, we have 2 studies, both of which dem...

Dear Kit1018, If not done, I would suggest, in addition to what Multibilly has suggested, a 24-hour urine protein electrophoresis and immunofixation to quantify the amount of total protein you are spilling in your urine over a 24-hour period and to determine if there are any monoclonal free kappa li...