[LKBrannagan]

Smoldering so far, but should I start treatment?

by LKBrannagan on Sat Jul 23, 2016 10:05 pm

I have been doctoring for the last five years with smoldering multiple myeloma. At my last visit 2 days ago, the doctor thought perhaps that I should start treatments, but brought in a second doctor, who did not think so. So I would like a second opinion.

Here are some of my test results:

Kappa FLC 3.92
Lambda FLC 1.59
Kappa Lambda FLC ratio 2.47

Immunoglobulins are normal, normal WBC and RBC, platelets normal, hemoglobin normal.

I do have a low GFR rate because of having Wegener's granulomotosis several years ago, but recently it went down to 29, mostly due to medications I was taking for arthritis, and the Bactrim (sulfa­meth­ox­azole and tri­meth­oprim) I have taken for 30 years for the Wegeners.

Three months later, however, my GFR has increased to 37, after getting off the arthritis medications (ibuprofen and meloxicam).

What do you think of these results?

P.S. - I am a 74 year old woman.

[Multibilly]

Re: Smoldering so far, but should I start treatment?

by Multibilly on Sun Jul 24, 2016 8:25 am

Hi LKBrannagan,

What is your M-spike level? Also, what lab number put you in the smoldering category versus the MGUS category?

If your kidney function can be well-explained by your other condition, why did the first doctor suggest starting treatment at this point in time? Did some lab number start to go south on you?

[LKBrannagan]

Re: Smoldering so far, but should I start treatment?

by LKBrannagan on Sun Jul 24, 2016 2:33 pm

Thank you for responding to my question.

First of all, I guess I do not know what the M-spike is. Could it be listed a different way on my lab reports?

I believe the free light chain results that I posted, are what they were going by, but according to some of the results in other posts, I don't believe they are terribly high.

Confused!

[Multibilly]

Re: Smoldering so far, but should I start treatment?

by Multibilly on Sun Jul 24, 2016 3:26 pm

Your free light chain levels are indeed very modest and many folks on this forum wish they had these kinds of levels ... including me

Your M-spike would be listed on your serum protein electrophoresis (SPEP) test report. It may be referred to as an abnormal protein band, paraprotein, M-protein, monoclonal protein or something like that. It may also be called out in a separate notation on the test report. Please include the units of measure when you post the value.

Also, have you ever had a bone marrow biopsy and do you know your bone marrow plasma cell percentage (BMPC)?

You would need an M-spike of > 3 g/dL or a BMPC > 10% to have a diagnosis of smoldering multiple myeloma versus a diagnosis of MGUS.

[LKBrannagan]

Re: Smoldering so far, but should I start treatment?

by LKBrannagan on Sun Jul 24, 2016 3:35 pm

I believe after looking at my lab results, that my M-spike is 7.7 g/dL. It is listed as "Total Protein, Blood" on my reports.

Thanks for your help again.