[Niki]

Some help with test results

by Niki on Fri Dec 20, 2013 5:30 pm

Good evening everybody,

I was told that I am in CR 18 months ago. Now I had to repeat my 6 months tests for re-staging of the disease. So the results are that according to the PET-CT and sFLC I am in remission.

But I am worried about the beta 2 macroglobulin which has increased alot and the LDH which is above the normal levels. Could that be because of the maintenance therapy with VTD or because of a chronic lung infection? Is that a reason to worry?

Best regards
Niki

[dnalex]

Re: Some help with test results

by dnalex on Fri Dec 20, 2013 5:43 pm

It would seem that the elevated b2m and LDH is associated with the chronic lung infection and/or some other issue and not myeloma.

Best wishes.

[Niki]

Re: Some help with test results

by Niki on Fri Dec 20, 2013 6:25 pm

Hello dnalex,

thank you very much for your answer. That's what I hope for. Just I am afraid not to be the case of some early identified relapse, before the PET-CT could identified. I am an oligo-secretory patient and I monitor my disease through the s-FLC, because the were elevated a lot initially.

Best regards
Niki

[dnalex]

Re: Some help with test results

by dnalex on Fri Dec 20, 2013 11:34 pm

Niki,

Is the light chain assay not useful for measuring oligosecretory myeloma? Does your doctors do bloodwork that includes this?

[Niki]

Re: Some help with test results

by Niki on Sat Dec 21, 2013 7:03 am

Hi Dnalex,

Yes we follow the myeloma with the serum free light chain assays and they are all normal. Just we are afraid from the unexpected rise of B2M and LDH.

Best regards
Niki

[dnalex]

Re: Some help with test results

by dnalex on Sat Dec 21, 2013 7:02 pm

[quote="Niki"]Hi Dnalex,

Yes we follow the myeloma with the serum free light chain assays and they are all normal. Just we are afraid from the unexpected rise of B2M and LDH.

Best regards
Niki[/quote]

I would definitely ask your doctor about the elevated values of b2m and LDH, but as I understand it, b2m is an indicator of tumor burden, and LDH is an indicator of tissue/cell damage. I think you would see a rise in the other tests (light chain, for example) concomitant with b2m and LDH elevation, if this were to be myeloma. Combined with the other tests, I think it's more than reasonable to conclude that it's not an early myeloma warning sign.

[Dr. Ken Shain]

Re: Some help with test results

by Dr. Ken Shain on Sun Dec 22, 2013 11:47 pm

I am glad to hear that your myeloma labs and bone marrow biopsy have demonstrated a complete response (an absence of serum and urine paraproteins by electrophoresis and immunofixation and no increaese in clonal plasma cells on bone marrow biopsy). Without the actual levels of beta or LDH is difficult to state with certainty there etiology. However, I do agree with other post that they are more likely related to chronic issues revolving around either consolidation with VTD or other issues especially if you are post HDM-ASCT.

This are not likely secondary to relapsed disease. However, it is always wise to keep a close eye on everything and please keep us posted.

Merry Christmas and Happy New Year.

[Niki]

Re: Some help with test results

by Niki on Mon Dec 23, 2013 4:55 am

Thank you very much Dr. Shain . I wish you and your family merry Christmas and a happy New Year too.

Best regards
Niki