Hi All,
Just hoping to get a little insight on how to read results / measure "reactiveness" to the drugs.
My mom was diagnosed with myeloma in the spring. They have started her on a 4 week protocol that involves weekly: dexamethasone, subcutaneous bortezomib [Velcade], and oral cyclophosphamide [Cytoxan].
Lambda Kappa IgA IgG
FLC FLC
(mg/L) (mg/L) (g/L) (g/L)
2014-05-07 577 1.9 0.28 2.6
2014-06-19 518 1.9 0.25 2.8
2014-07-14 557 1.7 0.25 2.7
*started chemo here*
2014-08-27 414 1.6 NR NR
2014-10-01 562 2.1 0.22 2.1
NR = No result
Can someone help me read these, we were quite happy to see the lambdas down on the 27th of August, but they are back up on the 1st of October after the 2nd cycle.
I had test cancer myself (6 years no remission!!), so am familiar with certain aspects, but I am wondering if these are discouraging with the lambda light chains coming back up after the second cycle, or if I should be looking at different ratios.
Her last call with her doctor unfortunately left (my mom) a bit confused and we won't be seeing the doctor for a few weeks, so hoping for a bit of anecdotal input from the community. Any general info would help! But, really curious if we should be seeing a downward trend, upward trend, etc by now at least in your experience.
Keep fighting the good fight - and thanks in advance!
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Re: Tracking my mother's response to treatment
Hi bucket,
Welcome to the forum.
You're tracking some of the right things, but not all of them.
A key thing you're missing is the value of your mother's paraprotein (monoclonal protein m-protein, or "M-spike"). That's something that will be reported as the result of a serum protein electrophoresis (SPEP) test. It will be reported in units of either g/L or g/dL. It's important to make sure to get the units right.
Speaking of units, are you sure you have them correct in the data you've tabulated? The units for the FLC levels look correct, but I think the units for the IgA and IgG levels should be g/dL, not g/L. Can you check on that?
Here are the things you probably want to track to see how your mother's disease is responding to treatment:
1. M-spike (m-protein, paraprotein, monoclonal protein)
2. Immunoglobulin levels (IgG, IgA, and perhaps IgM)
3. Free light chain levels (lambda, kappa, ratio)
4. Creatinine, hemoglobin, and calcium levels in the blood
It looks like your mother has the IgG lambda type of myeloma, so watching her IgG level and her lambda FLC level are particularly important in her case.
Here are some reference (normal) ranges for you:
Lambda free light chains: 5.7 - 26.3 mg/L
Kappa free light chains: 3.3 - 19.4 mg/L
IgG: 0.8 - 1.6 g/dL (767-1,590 mg/dL)
IgA: 0.06 - 0.4 g/dL (61-356 mg/dL)
The goal of treatment is to get a patient's M-spike to zero. A healthy person who does not have myeloma does not have an M-spike, since by definition it measures monoclonal proteins, which are produced by myeloma cells.
Hope this helps a bit. Good luck, and congratulations on being in remission for so long from your own cancer.
Welcome to the forum.
You're tracking some of the right things, but not all of them.
A key thing you're missing is the value of your mother's paraprotein (monoclonal protein m-protein, or "M-spike"). That's something that will be reported as the result of a serum protein electrophoresis (SPEP) test. It will be reported in units of either g/L or g/dL. It's important to make sure to get the units right.
Speaking of units, are you sure you have them correct in the data you've tabulated? The units for the FLC levels look correct, but I think the units for the IgA and IgG levels should be g/dL, not g/L. Can you check on that?
Here are the things you probably want to track to see how your mother's disease is responding to treatment:
1. M-spike (m-protein, paraprotein, monoclonal protein)
2. Immunoglobulin levels (IgG, IgA, and perhaps IgM)
3. Free light chain levels (lambda, kappa, ratio)
4. Creatinine, hemoglobin, and calcium levels in the blood
It looks like your mother has the IgG lambda type of myeloma, so watching her IgG level and her lambda FLC level are particularly important in her case.
Here are some reference (normal) ranges for you:
Lambda free light chains: 5.7 - 26.3 mg/L
Kappa free light chains: 3.3 - 19.4 mg/L
IgG: 0.8 - 1.6 g/dL (767-1,590 mg/dL)
IgA: 0.06 - 0.4 g/dL (61-356 mg/dL)
The goal of treatment is to get a patient's M-spike to zero. A healthy person who does not have myeloma does not have an M-spike, since by definition it measures monoclonal proteins, which are produced by myeloma cells.
Hope this helps a bit. Good luck, and congratulations on being in remission for so long from your own cancer.
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