This week's poll is about serum (blood) M-spike levels at the time of multiple myeloma diagnosis.
Plasma cells typically produce a variety of antibodies that fight infection. However, people with MGUS, smoldering myeloma, multiple myeloma, and other related conditions have abnormal plasma cells that produce the same type of abnormal antibody that is unable to fight infection.
This abnormal antibody is known as monoclonal protein (M-protein). This M-protein is often found in large amounts in the blood and urine. M-spike refers to the sharp peak that occurs on protein electrophoresis when M-protein is present. In some countries, the M-spike is referred to as the paraprotein, or paraprotein level.
A few important clarifications about this week's poll:
First, this poll is for people whose first myeloma-related diagnosis was multiple myeloma. If you were diagnosed with smoldering myeloma or MGUS prior to progressing to multiple myeloma, please do not respond to this poll. (We will soon do separate polls for smoldering myeloma and MGUS.)
Second, if you are a caregiver or family member of a multiple myeloma patient, feel free to answer on their behalf.
Third, please answer the poll based on the values from your serum (blood) protein electrophoresis or immunofixation at diagnosis, not your urine test results. Also, please use the test result that was nearest to the date you were actually diagnosed with multiple myeloma, but before you started any treatment for your myeloma.
Fourth - and very important -- please note that M-spikes are typically reported with units of g/dL in the United States, but are often reported with units of g/L in many other countries. To convert from g/L to g/dL, simply divide the g/L number by 10. For example, an M-spike of 10 g/L is equivalent to 1.0 g/dL.
Fifth, if you did not have an M-spike at the time of your diagnosis, either because you are non-secretory, or because you have light chain myeloma, please select the first ("0") option from the list of answers.
As always, feel free to post comments, thoughts, or feedback about this week's poll in the space below. They can be very useful to other readers.
Forums
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
My spike was 98 G/L, so that would be 9.8. It took a long time for doctors to figure out I had multiple myeloma. I was in my early 30's and only diagnosed when I developed hyperviscosity syndrome because of the high M-spike. After attending the ER for fainting, the ER blood work showed I was really messed up, but it took another week to figure out multiple myeloma, confirmed by a bone marrow biopsy.
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lys2012 - Name: Alyssa
- When were you/they diagnosed?: 2010, Toronto, Canada
- Age at diagnosis: 32
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
My husband was diagnosed with multiple myeloma in February of this year. We have our family internist to thank for the quick response time.
My husband is diabetic and has dementia, so 2-3 times a year, a complete profile of the blood is done, including checking the A1C levels. In September of 2012 the protein levels came back suspect, and it was decided to retest in 3 months. In December 2012 those test results continued to baffle our doctor, so my husband was referred to a hematologist/oncologist. My husband had no physical symptoms whatsoever.
In January 2014 we met with the oncologist who ordered specialized blood work, a bone survey x-ray, and a bone marrow biopsy. Over a course of a month, all tests confirmed the multiple myeloma diagnosis. His abnormal protein level was a 3.23. His albumin was as high as the abnormal protein. My husband had two choices: do nothing, or begin treatment. His response was immediate: "How soon can I start?"
He began his twice weekly chemotherapy treatments the following week. His cocktail of choice includes 2 steroids and Velcade. His regimen was 2 weeks on, one week off. After 11 treatments, his body responded very well. As of March 24, the abnormal protein was a 0.7. He has had no side effects, which we are very grateful for. He remains very positive. However, his bilirubin levels are on the rise, so we are temporarily "on hold."
We saw the oncologist yesterday, and he repeated more blood work, including testing for the M protein level. We are patiently awaiting those results. Once the bilirubin levels come down, he will be free to resume chemo, and his treatments will be only once a week. A much better fit for him.
My husband is diabetic and has dementia, so 2-3 times a year, a complete profile of the blood is done, including checking the A1C levels. In September of 2012 the protein levels came back suspect, and it was decided to retest in 3 months. In December 2012 those test results continued to baffle our doctor, so my husband was referred to a hematologist/oncologist. My husband had no physical symptoms whatsoever.
In January 2014 we met with the oncologist who ordered specialized blood work, a bone survey x-ray, and a bone marrow biopsy. Over a course of a month, all tests confirmed the multiple myeloma diagnosis. His abnormal protein level was a 3.23. His albumin was as high as the abnormal protein. My husband had two choices: do nothing, or begin treatment. His response was immediate: "How soon can I start?"
He began his twice weekly chemotherapy treatments the following week. His cocktail of choice includes 2 steroids and Velcade. His regimen was 2 weeks on, one week off. After 11 treatments, his body responded very well. As of March 24, the abnormal protein was a 0.7. He has had no side effects, which we are very grateful for. He remains very positive. However, his bilirubin levels are on the rise, so we are temporarily "on hold."
We saw the oncologist yesterday, and he repeated more blood work, including testing for the M protein level. We are patiently awaiting those results. Once the bilirubin levels come down, he will be free to resume chemo, and his treatments will be only once a week. A much better fit for him.
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
I wonder if the Beacon folks could do a poll of starting IgG levels (or whatever your 'bad' protein is).
I think that would be interesting to see the results.
I think that would be interesting to see the results.
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RayGunter - Name: Ray Gunter
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 38
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
I am stunned that the > 8 category had the most replies. Makes me wonder how many years folks went undiagnosed with multiple myeloma. I was fortunate to have an astute GP that picked up on my SMM by noticing just a small uptick in my globulin level during a routine physical.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
Thanks everyone for all the responses to the poll and to the comments that were posted about it.
Ray - We probably will run additional polls related to other lab values at diagnosis. Thanks for the suggestion.
Multibilly - It's possible that the large number of responses in the ">8" category may be due to some people forgetting to convert their values from g/L to g/dL. We've edited the instructions for the poll slightly to emphasize the need to do this conversion if a person's lab results are in g/L.
Ray - We probably will run additional polls related to other lab values at diagnosis. Thanks for the suggestion.
Multibilly - It's possible that the large number of responses in the ">8" category may be due to some people forgetting to convert their values from g/L to g/dL. We've edited the instructions for the poll slightly to emphasize the need to do this conversion if a person's lab results are in g/L.
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
Multibilly wrote: "I am stunned that the > 8 category had the most replies. Makes me wonder how many years folks went undiagnosed with multiple myeloma. I was fortunate to have an astute GP that picked up on my SMM by noticing just a small uptick in my globulin level during a routine physical."
I think my case is one that might relate to the question of timing. I had had CLL for 8 years prior to being diagnosed with multiple myeloma. In fact, when I was diagnosed, it was because of a CBC taken to monitor my CLL. My WBC was 54, my hemoglobin was 7.4, and my creatinine was 6.5. This came about in a matter of about 3 or 4 months by my calculations, based on symptoms.
I think my case is one that might relate to the question of timing. I had had CLL for 8 years prior to being diagnosed with multiple myeloma. In fact, when I was diagnosed, it was because of a CBC taken to monitor my CLL. My WBC was 54, my hemoglobin was 7.4, and my creatinine was 6.5. This came about in a matter of about 3 or 4 months by my calculations, based on symptoms.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
Multibilly - My PCP first noticed that my calcium level was way up there back in 2011. He diagnosed it as a vitamin D deficiency and sent me on my way. A year later, I started with a new PCP who noted the blood issues and sent me to a hematologist right away. Even after that, I was only at 4.0 or so on the M-spike scale. Still, I probably should have been diagnosed a year earlier.
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Mike F - Name: Mike F
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: May 18, 2012
- Age at diagnosis: 53
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
Please help me with conversions; does 200mg/dl equal 0.2g/dl or 2.0g/dl.
Thanks,
Coach Hoke (math challenged)
Thanks,
Coach Hoke (math challenged)
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Weekly Poll - M-Spike At Multiple Myeloma Diagnosis 2014
Hi Coach, in the metric system, a milligram is 1/1000 of a gram. It's like 1 metre = 100 centimetres = 1000 millimetres for linear measurement.
Thus, 2 g/dl = 2000 mg/dl. So, 200 mg = 0.2 g/dl.
We had to switch over from the Imperial/American system to the metric system here in 1974. That was very confusing to us. Gasoline went from being sold in gallons to litres; temperature went from being measured in Fahrenheit to Celsius! It was a real learning curve.
Thus, 2 g/dl = 2000 mg/dl. So, 200 mg = 0.2 g/dl.
We had to switch over from the Imperial/American system to the metric system here in 1974. That was very confusing to us. Gasoline went from being sold in gallons to litres; temperature went from being measured in Fahrenheit to Celsius! It was a real learning curve.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
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