Hi,
I just got these lab results back and they want me to see an oncologist. Can some please help me understand the lab results?
Thank you all!
Immunofixation, Serum
Faint band in IgA and kappa is present against a dense polyclonal background. While this may represent a reactive/inflammatory process, a developing plasma cell disorder cannot be excluded. Clinical correlation is suggested and if indicated repeat the immunofixation testing in 3-6 months.
Immunofixation, Urine
Free kappa (monoclonal free light chain) band present
Protein Fractions, Urine
Urine protein electrophoresis reveals proteinuria, predominantly albumin. There is no evidence of a paraproteinuria.
C-Reactive Protein
5.42 <3.00
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Re: Told to see oncologist based on lab results - why?
Hi Antimo,
Welcome to the forum.
It seems like there is a faint band on your serum immunofixation test, which could potentially represent the presence of monoclonal protein in your blood. Also, the presence of monoclonal free light chains was registered in your urine, but it looks like there wasn't enough to actually measure it.
Did your doctor also order a serum protein electrophoresis test? Do you have those results?
Also, do you know why your doctor order these tests in the first place? These aren't normal tests to get as part of a routine exam, so your doctor must have suspected something.
Given the IgA faint band is just barely being registered, the explanation and recommendation provided below seems pretty reasonable to me (but I'm not a doc). Also the possibility of some reactive/inflammation process other than a plasma cell disorder is certainly plausible since your have a pretty high CRP level (which is a measure of inflammation in your body). But be clear that a plasma cell disorder can also elevate one's CRP level, so you definitely want to follow up on why your CRP is elevated.
"While this may represent a reactive/inflammatory process, a developing plasma cell disorder cannot be excluded. Clinical correlation is suggested and if indicated repeat the immunofixation testing in 3-6 months".
If a plasma cell disorder is developing, it potentially could be a condition known as MGUS. Patients with MGUS are usually none the worse for it and MGUS normally doesn't evolve into a more serious condition such as multiple myeloma. In fact the risk of MGUS developing into something like multiple myeloma is only about 1-2%/year.
In any case, following up with a hematologist/oncologist is the right thing to do since they are much more familiar in evaluating potential plasma cell disorders such as MGUS. But I bet your hematologist/oncologist will likely suggest that you simply get re-tested in a few months to see if these results normalize.
Hope this helps a bit. Please let us know how things turn out.
Welcome to the forum.
It seems like there is a faint band on your serum immunofixation test, which could potentially represent the presence of monoclonal protein in your blood. Also, the presence of monoclonal free light chains was registered in your urine, but it looks like there wasn't enough to actually measure it.
Did your doctor also order a serum protein electrophoresis test? Do you have those results?
Also, do you know why your doctor order these tests in the first place? These aren't normal tests to get as part of a routine exam, so your doctor must have suspected something.
Given the IgA faint band is just barely being registered, the explanation and recommendation provided below seems pretty reasonable to me (but I'm not a doc). Also the possibility of some reactive/inflammation process other than a plasma cell disorder is certainly plausible since your have a pretty high CRP level (which is a measure of inflammation in your body). But be clear that a plasma cell disorder can also elevate one's CRP level, so you definitely want to follow up on why your CRP is elevated.
"While this may represent a reactive/inflammatory process, a developing plasma cell disorder cannot be excluded. Clinical correlation is suggested and if indicated repeat the immunofixation testing in 3-6 months".
If a plasma cell disorder is developing, it potentially could be a condition known as MGUS. Patients with MGUS are usually none the worse for it and MGUS normally doesn't evolve into a more serious condition such as multiple myeloma. In fact the risk of MGUS developing into something like multiple myeloma is only about 1-2%/year.
In any case, following up with a hematologist/oncologist is the right thing to do since they are much more familiar in evaluating potential plasma cell disorders such as MGUS. But I bet your hematologist/oncologist will likely suggest that you simply get re-tested in a few months to see if these results normalize.
Hope this helps a bit. Please let us know how things turn out.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Told to see oncologist based on lab results - why?
Hi,,
I am confused about this SPEP test results, If someone could please give me a little insight on this?
Thank you!
Antimo
SPEP, PROTEIN ELECTRO SERUM 05/04/2016 (Final, 04/29/2016 11:42am)
Report Status Lab
PROTEIN, TOTAL 7.3 6.1-8.1 g/dL Normal Final QUEST
ALBUMIN 4.4 3.8-4.8 g/dL Normal Final QUEST
ALPHA 1 GLOBULIN 0.3 0.2-0.3 g/dL Normal Final QUEST
ALPHA 2 GLOBULIN 0.6 0.5-0.9 g/dL Normal Final QUEST
BETA 1 GLOBULIN 0.5 0.4-0.6 g/dL Normal Final QUEST
BETA 2 GLOBULIN 0.5 0.2-0.5 g/dL Normal Final QUEST
GAMMA GLOBULIN 0.9 0.8-1.7 g/dL Normal Final QUEST
INTERPRETATION RESULT BELOW Normal Final QUEST
Faint band visible with overall polyclonal pattern in the gamma
region. This may represent an inflammatory or acute phase
response, but a developing plasma cell disorder cannot be excluded.
Serum and urine immunofixation may be useful, if clinically indicated.
I am confused about this SPEP test results, If someone could please give me a little insight on this?
Thank you!
Antimo
SPEP, PROTEIN ELECTRO SERUM 05/04/2016 (Final, 04/29/2016 11:42am)
Report Status Lab
PROTEIN, TOTAL 7.3 6.1-8.1 g/dL Normal Final QUEST
ALBUMIN 4.4 3.8-4.8 g/dL Normal Final QUEST
ALPHA 1 GLOBULIN 0.3 0.2-0.3 g/dL Normal Final QUEST
ALPHA 2 GLOBULIN 0.6 0.5-0.9 g/dL Normal Final QUEST
BETA 1 GLOBULIN 0.5 0.4-0.6 g/dL Normal Final QUEST
BETA 2 GLOBULIN 0.5 0.2-0.5 g/dL Normal Final QUEST
GAMMA GLOBULIN 0.9 0.8-1.7 g/dL Normal Final QUEST
INTERPRETATION RESULT BELOW Normal Final QUEST
Faint band visible with overall polyclonal pattern in the gamma
region. This may represent an inflammatory or acute phase
response, but a developing plasma cell disorder cannot be excluded.
Serum and urine immunofixation may be useful, if clinically indicated.
Re: Told to see oncologist based on lab results - why?
Antimo,
I'm not a doc, but the explanation of your latest results seems largely the same as the explanation of your previous test results.
Did the doctor measure your serum free light chains or run any other tests other than a serum protein electro test this latest time around?
What did the oncologist suggest was the cause of your lab results when you last spoke with him/her?
I'm not a doc, but the explanation of your latest results seems largely the same as the explanation of your previous test results.
Did the doctor measure your serum free light chains or run any other tests other than a serum protein electro test this latest time around?
What did the oncologist suggest was the cause of your lab results when you last spoke with him/her?
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Told to see oncologist based on lab results - why?
Hello again to all,
Just had a bone marrow test, but I have no clue what this test results mean. Could anyone help me understand this result.
Thank you all for your help, I do really appreciate it so much. I am so confused!
Bless you all!
Antimo
DIAGNOSIS:
Bone marrow aspirate:
- Cellular marrow aspirate with trilineage hematopoiesis; no overt evidence of non-Hodgkin lymphoma or plasma cell dyscrasia
Comment: No core biopsy submitted. The corresponding flow cytometry (OSO-16-1391) is also negative.
88311, 88313, 85097
GROSS DESCRIPTION:
7 slides received, 3 stained with Giemsa-wright, and one for an iron stain. No bone marrow core biopsy nor blood clot received.
MICROSCOPIC DESCRIPTION:
Moderately cellular marrow aspirate smears show an M:E ratio of approximately 4:1 with progressive maturation evident in both the erythroid and myeloid cell lines. Mature granulocytic elements are readily identified. Myeloblasts comprise 1% of overall cellularity. Erythropoiesis is overall normoblastic. Megakaryocytes are present in adequate numbers for marrow cellularity. Scattered lymphocytes and plasma cells are present comprising 6% and 1% of overall cellularity respectively, without large or atypical forms present. Stainable iron is present in increased amount with no ringed sideroblasts identified.
Final Diagnosis performed by X, MD. Electronically signed 6/8/2016 16:52
Just had a bone marrow test, but I have no clue what this test results mean. Could anyone help me understand this result.
Thank you all for your help, I do really appreciate it so much. I am so confused!
Bless you all!
Antimo
DIAGNOSIS:
Bone marrow aspirate:
- Cellular marrow aspirate with trilineage hematopoiesis; no overt evidence of non-Hodgkin lymphoma or plasma cell dyscrasia
Comment: No core biopsy submitted. The corresponding flow cytometry (OSO-16-1391) is also negative.
88311, 88313, 85097
GROSS DESCRIPTION:
7 slides received, 3 stained with Giemsa-wright, and one for an iron stain. No bone marrow core biopsy nor blood clot received.
MICROSCOPIC DESCRIPTION:
Moderately cellular marrow aspirate smears show an M:E ratio of approximately 4:1 with progressive maturation evident in both the erythroid and myeloid cell lines. Mature granulocytic elements are readily identified. Myeloblasts comprise 1% of overall cellularity. Erythropoiesis is overall normoblastic. Megakaryocytes are present in adequate numbers for marrow cellularity. Scattered lymphocytes and plasma cells are present comprising 6% and 1% of overall cellularity respectively, without large or atypical forms present. Stainable iron is present in increased amount with no ringed sideroblasts identified.
Final Diagnosis performed by X, MD. Electronically signed 6/8/2016 16:52
Re: Told to see oncologist based on lab results - why?
More info.
ICD-10: D47.2
CPT: 88184, 88185 x 17, 88189
Results
Antibody Description Results
CD5 Pan-T cell antigen, B cell subset, B-CLL 6%
CD10 Precursor Lymphomas and Leukemias <0.5%
CD15 Myeloid cells 53%
CD19 Pan B-cell antigen <0.5%
CD20 Mature B cells <0.5%
CD23 Activated B cells, Chronic lymphocytic leukemias <0.5%
CD38 Plasma cells, stem cells, myeloid cells 70%
CD45 Pan leukocyte antigen 100%
CD56 T cell subset, NK , neoplastic plasma cells 10%
CD117 C-Kit 10%
CD138 Plasma cells, B lymphocytes 20%
sKappa B lymphocytes <0.5%
sLambda B lymphocytes <0.5%
cKappa Plasma cells, B lymphocytes <0.5%
cLambda Plasma cells, B lymphocytes <0.5%
cIgG Plasma cells, B lymphocytes <0.5%
cIgA Plasma cells, B lymphocytes <0.5%
cIgM Plasma cells, B lymphocytes <0.5%
Immunophenotypic Analysis
Viability 7ADD- 99% Target Cell Population: Erythroid and myeloid cells by CD45 vs. Side Scatter
Flow cytometric analysis of this marrow aspirate identifies approximately 48% myeloid cells, <1% plasma cells and 6% lymphocytes of which <1% are B-lymphocytes and 6% are T-lymphocytes. B-lymphocytes and plasma cells are polyclonal.
These tests were developed and their performance characteristics determined Laboratories. They may not be cleared or approved by the U.S. Food and Drug Administration. The FDA
has determined that such clearance or approval is not necessary. These tests are used for clinical purposes. They should not be regarded as investigational or for research. This lab has been approved by CLIA 88, designated as a high complexity laboratory and is qualified to perform these tests.
ICD-10: D47.2
CPT: 88184, 88185 x 17, 88189
Results
Antibody Description Results
CD5 Pan-T cell antigen, B cell subset, B-CLL 6%
CD10 Precursor Lymphomas and Leukemias <0.5%
CD15 Myeloid cells 53%
CD19 Pan B-cell antigen <0.5%
CD20 Mature B cells <0.5%
CD23 Activated B cells, Chronic lymphocytic leukemias <0.5%
CD38 Plasma cells, stem cells, myeloid cells 70%
CD45 Pan leukocyte antigen 100%
CD56 T cell subset, NK , neoplastic plasma cells 10%
CD117 C-Kit 10%
CD138 Plasma cells, B lymphocytes 20%
sKappa B lymphocytes <0.5%
sLambda B lymphocytes <0.5%
cKappa Plasma cells, B lymphocytes <0.5%
cLambda Plasma cells, B lymphocytes <0.5%
cIgG Plasma cells, B lymphocytes <0.5%
cIgA Plasma cells, B lymphocytes <0.5%
cIgM Plasma cells, B lymphocytes <0.5%
Immunophenotypic Analysis
Viability 7ADD- 99% Target Cell Population: Erythroid and myeloid cells by CD45 vs. Side Scatter
Flow cytometric analysis of this marrow aspirate identifies approximately 48% myeloid cells, <1% plasma cells and 6% lymphocytes of which <1% are B-lymphocytes and 6% are T-lymphocytes. B-lymphocytes and plasma cells are polyclonal.
These tests were developed and their performance characteristics determined Laboratories. They may not be cleared or approved by the U.S. Food and Drug Administration. The FDA
has determined that such clearance or approval is not necessary. These tests are used for clinical purposes. They should not be regarded as investigational or for research. This lab has been approved by CLIA 88, designated as a high complexity laboratory and is qualified to perform these tests.
Re: Told to see oncologist based on lab results - why?
I would say the key finding in the biopsy results is this one:
"no overt evidence of non-Hodgkin lymphoma or plasma cell dyscrasia"
which means there is no sign in the biopsy results of either non-Hodgkin lymphoma or a plasma cell disorder (dyscrasia), which includes diseases such as multiple myeloma, amyloidosis, Waldenstrom's, POEMS, and light chain deposition disease.
For a thorough understanding of the details, however, you'll have to get feedback from your specialist.
Good luck, and let us know what you find out.
"no overt evidence of non-Hodgkin lymphoma or plasma cell dyscrasia"
which means there is no sign in the biopsy results of either non-Hodgkin lymphoma or a plasma cell disorder (dyscrasia), which includes diseases such as multiple myeloma, amyloidosis, Waldenstrom's, POEMS, and light chain deposition disease.
For a thorough understanding of the details, however, you'll have to get feedback from your specialist.
Good luck, and let us know what you find out.
-
JimNY
Re: Told to see oncologist based on lab results - why?
Hi,
These are my latest results. Is this ok? Or should I be concerned?
Thank you all! God Bless.
July 11, 2016
Free Light Chains, Serum
Kappa/Lambda Ratio - 1.92 [0.26-1.65 ] High
Kappa Free Light Chain Level - 2.21 mg/dL [0.33-1.94 mg/dL] High
Lambda Free Light Chain Level - 1.15 mg/dL [0.57-2.63 mg/dL]
These are my latest results. Is this ok? Or should I be concerned?
Thank you all! God Bless.
July 11, 2016
Free Light Chains, Serum
Kappa/Lambda Ratio - 1.92 [0.26-1.65 ] High
Kappa Free Light Chain Level - 2.21 mg/dL [0.33-1.94 mg/dL] High
Lambda Free Light Chain Level - 1.15 mg/dL [0.57-2.63 mg/dL]
Re: Told to see oncologist based on lab results - why?
You have a very slight excess in the kappa free light chain and that has your ratio slightly above normal. However, these readings are only slightly above normal, and that coupled with the fact that your other tests are normal, would not alarm me. At the very worst, you might have a slight case of monoclonal gammopathy of unknown significance ("MGUS"), which means you may need to be periodically retested (maybe once every 6 months or so). Many people who have low level MGUS never develop multiple myeloma.
-
Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
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