Hello,
My name is Colleen and I was diagnosed with smoldering myeloma back in March 2015. I am getting ready to go back to my oncologist next week. My labs are in. I believe they are written in English, but I've read it multiple times and have no idea at all what is being said. Unfortunately, there doesn't seem to be a Khan Academy that can teach me what I need to know about my labs. I posted below my labs. Can anyone tell me what this means?
Grateful,
Colleen
Protein Electrophoresis Serum - Details
Component Standard Range Your Value
Albumin Electrophoresis 3.50 - 4.70 g/dL 4.11
Alpha-1-Globulin 0.10 - 0.30 g/dL 0.21
Alpha-2-Globulin 0.60 - 1.00 g/dL 0.87
Beta Globulin 0.70 - 1.20 g/dL 1.67
Gamma Globulin 0.70 - 1.50 g/dL 1.23
Interpretation:
Two discrete abnormal bands detected in serum. The prominent anodal component co-migrates with the normal beta-2 globulins and measures 1.2 g/dL in aggregate. In addition, a second faint band is found in the anodal gamma region that measures 0.2 g/dL with suppression of the background polyclonal gamma globulins. On 5/7/2015, the anodal band co-migrating with normal beta-2 globulins measured 1.4 g/dL in aggregate and the second, faint band also measured 0.2 g/dL. Previous serum immunofixation electrophoresis (IFE) characterized both components as monoclonal IgA kappa, which likely represent monomeric and dimeric forms of the same protein.
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• Page 1 of 1
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ColleenM - Name: Colleen Mabasa
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: March 2015
- Age at diagnosis: 41
Re: Understanding serum protein electrophoresis report
Two items:
To my unscientific eye, your labs look good--looks like most all within ranges / values for that lab. Albumin is good; globulins are good.
Beta is not specific, could just be inflammation, etc.?
I have never seen a combined Two IFE report before--so I can't really help you there.
Good Luck.
To my unscientific eye, your labs look good--looks like most all within ranges / values for that lab. Albumin is good; globulins are good.
Beta is not specific, could just be inflammation, etc.?
I have never seen a combined Two IFE report before--so I can't really help you there.
Good Luck.
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Rneb
Re: Understanding serum protein electrophoresis report
Thanks Rneb,
I go to Smilow in Connecticut and I've noticed that all my labs look different than what most people post. I don't know if that is good or bad. I appreciate your feedback.
Sincerely,
Colleen
I go to Smilow in Connecticut and I've noticed that all my labs look different than what most people post. I don't know if that is good or bad. I appreciate your feedback.
Sincerely,
Colleen
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ColleenM - Name: Colleen Mabasa
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: March 2015
- Age at diagnosis: 41
Re: Understanding serum protein electrophoresis report
Hi Colleen,
It looks like you have two M-spikes, rather than just one. You'll see that sometimes here in the lab results posted in the forum. See, for example, the lab results posted in this forum thread related to forum member's mother who was diagnosed with smoldering myeloma last year:
"Questions from France about smoldering myeloma" (started Apr 22, 2014)
She also was diagnosed with IgA smoldering myeloma, although she has IgA lambda rather than IgA kappa, which you appear to have.
(My sense is that this phenomenon of two M-spikes is more prevalent in IgA myeloma. That's because immunoglobulin A – IgA – can take both a "monomeric" form, which is just one IgA molecule, or a dimeric form, which is two IgA molecules joined together. This is something alluded to in the interpretation of your SPEP.)
In any case, to find your total M-spike – which is a key metric that myeloma patients use to monitor their disease and how it responds to treatment – you need to take the sum of the two M-spikes measured at the two lab test dates mentioned in your lab report.
For the current test, your M-spike is 1.2 g/dL + 0.2 g/dL = 1.4 g/dL.
For your test done on May 7, 2015, your M-spike was 1.4 g/dL + 0.2 g/dL = 1.6 g/dL.
M-spikes measurement for IgA myeloma patients is not as accurate as it is for, say, IgG myeloma patients. That's why myeloma specialists often track the overall IgA level of patients with IgA myeloma. It generally moves in parallel with the IgA M-spike, but isn't subject to the same measurement error.
Another key test result you want to look at is your serum free light chain test results, which will have kappa, lambda, and kappa-lambda ratio results. These also will be important for tracking your smoldering myeloma and determining what risk you are at for potentially progressing to symptomatic myeloma requiring treatment (something which we all hope will never be necessary!).
If you look at other threads here in the forum started by people asking for help interpreting their lab results, you'll get useful recommendations as to what lab results to track and how to interpret them.
If you need more help interpreting your results, just let us know.
Good luck!
It looks like you have two M-spikes, rather than just one. You'll see that sometimes here in the lab results posted in the forum. See, for example, the lab results posted in this forum thread related to forum member's mother who was diagnosed with smoldering myeloma last year:
"Questions from France about smoldering myeloma" (started Apr 22, 2014)
She also was diagnosed with IgA smoldering myeloma, although she has IgA lambda rather than IgA kappa, which you appear to have.
(My sense is that this phenomenon of two M-spikes is more prevalent in IgA myeloma. That's because immunoglobulin A – IgA – can take both a "monomeric" form, which is just one IgA molecule, or a dimeric form, which is two IgA molecules joined together. This is something alluded to in the interpretation of your SPEP.)
In any case, to find your total M-spike – which is a key metric that myeloma patients use to monitor their disease and how it responds to treatment – you need to take the sum of the two M-spikes measured at the two lab test dates mentioned in your lab report.
For the current test, your M-spike is 1.2 g/dL + 0.2 g/dL = 1.4 g/dL.
For your test done on May 7, 2015, your M-spike was 1.4 g/dL + 0.2 g/dL = 1.6 g/dL.
M-spikes measurement for IgA myeloma patients is not as accurate as it is for, say, IgG myeloma patients. That's why myeloma specialists often track the overall IgA level of patients with IgA myeloma. It generally moves in parallel with the IgA M-spike, but isn't subject to the same measurement error.
Another key test result you want to look at is your serum free light chain test results, which will have kappa, lambda, and kappa-lambda ratio results. These also will be important for tracking your smoldering myeloma and determining what risk you are at for potentially progressing to symptomatic myeloma requiring treatment (something which we all hope will never be necessary!).
If you look at other threads here in the forum started by people asking for help interpreting their lab results, you'll get useful recommendations as to what lab results to track and how to interpret them.
If you need more help interpreting your results, just let us know.
Good luck!
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Jonah
Re: Understanding serum protein electrophoresis report
Hi Jonah,
Interesting enough, the kappa lambda test result was the other test that I didn't understand. My results are below. The 1st number under what the ratio is suppose to be is from May 7, 2015 and the second number is from July 15, 2015.
Test Normal Range May 7, 2015 Jul 15, 2015
Ig Kappa FLC 0.33 - 1.94 mg/dL 3.30 3.09
Ig Lambda FLC 0.57 - 2.63 mg/dL 0.52 0.25
Kappa/Lambda FLC Ratio 0.26 - 1.65 6.35 12.36
How should I look at these results in conjunction with the other to monitor progression?
Grateful,
Colleen
Interesting enough, the kappa lambda test result was the other test that I didn't understand. My results are below. The 1st number under what the ratio is suppose to be is from May 7, 2015 and the second number is from July 15, 2015.
Test Normal Range May 7, 2015 Jul 15, 2015
Ig Kappa FLC 0.33 - 1.94 mg/dL 3.30 3.09
Ig Lambda FLC 0.57 - 2.63 mg/dL 0.52 0.25
Kappa/Lambda FLC Ratio 0.26 - 1.65 6.35 12.36
How should I look at these results in conjunction with the other to monitor progression?
Grateful,
Colleen
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ColleenM - Name: Colleen Mabasa
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: March 2015
- Age at diagnosis: 41
Re: Understanding serum protein electrophoresis report
Good morning, Colleen:
Your lab results use somewhat different terminology that I am used to, so I cannot give any good commentary on interpreting them. However, I would suggest that what you really need to do is as follows. Have your doctor explain to you exactly what is your "M-spike". In some cases, SMM never develops to active symptomatic myeloma. Over time, the M-spike might start to slowly creep up. Just from my casual reading, it appears that many people start to develop symptoms when the M-spike hits the 3's or the 4's (in g/dL). Some people, however, go up to 5 and are still considered smoldering, and some people get symptoms in the 2's or less than 2.
You need to track it over time. If you are tracking every 3 months, and it stays flat for a year and a half, you might stretch that out to six months. If it is going up 0.1 or 0.2 every three months, then you need to be very diligent for the onset of symptoms.
Hope this helps, and good luck.
JPC
Your lab results use somewhat different terminology that I am used to, so I cannot give any good commentary on interpreting them. However, I would suggest that what you really need to do is as follows. Have your doctor explain to you exactly what is your "M-spike". In some cases, SMM never develops to active symptomatic myeloma. Over time, the M-spike might start to slowly creep up. Just from my casual reading, it appears that many people start to develop symptoms when the M-spike hits the 3's or the 4's (in g/dL). Some people, however, go up to 5 and are still considered smoldering, and some people get symptoms in the 2's or less than 2.
You need to track it over time. If you are tracking every 3 months, and it stays flat for a year and a half, you might stretch that out to six months. If it is going up 0.1 or 0.2 every three months, then you need to be very diligent for the onset of symptoms.
Hope this helps, and good luck.
JPC
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JPC - Name: JPC
Re: Understanding serum protein electrophoresis report
Hi Jonah,
Thank you so much for your help in understanding the significance if these labs. I am so grateful.
Sincerely,
Colleen
Thank you so much for your help in understanding the significance if these labs. I am so grateful.
Sincerely,
Colleen
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ColleenM - Name: Colleen Mabasa
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: March 2015
- Age at diagnosis: 41
Re: Understanding serum protein electrophoresis report
Hi Colleen,
Glad you found the postings here helpful.
You mentioned that you were diagnosed in March. Do you have any serum free light chain tests from then? Or were the first serum FLC tests done in May?
If you have serum (not urine) FLC tests from March, it might be worth comparing them to your May and July results, to see if there are any clear trends in them. Usually, the free light chain test is more sensitive in picking up changes in a person's myeloma than their M-spike.
Glad you found the postings here helpful.
You mentioned that you were diagnosed in March. Do you have any serum free light chain tests from then? Or were the first serum FLC tests done in May?
If you have serum (not urine) FLC tests from March, it might be worth comparing them to your May and July results, to see if there are any clear trends in them. Usually, the free light chain test is more sensitive in picking up changes in a person's myeloma than their M-spike.
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Jonah
Re: Understanding serum protein electrophoresis report
Hi Jonah,
I can check. I saw my oncologist. She said I am stable for now but is going to monitor me every two months because I have the IgA type. I was offered the clinical trial of Revlimid, but I am holding out for an immunotherapy clinical trial.
-Colleen
I can check. I saw my oncologist. She said I am stable for now but is going to monitor me every two months because I have the IgA type. I was offered the clinical trial of Revlimid, but I am holding out for an immunotherapy clinical trial.
-Colleen
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ColleenM - Name: Colleen Mabasa
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: March 2015
- Age at diagnosis: 41
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