Because Betsy50 is now a registered user, we've been able to go back and link all the postings she has made prior to her registration to her forum account.
So now, if you are logged in and click on her user name, you should be able to see a link to all her postings on her profile page. This link will also take you to that list.
Betsy50 - If we have missed any postings you have made in the past, before you registered, that should be linked to your account, please let us know what those postings are. You can just post links to the postings here in this thread; we'll remove the postings once we've linked the postings to your account.
Sorry we didn't get to this earlier.
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Re: What is "Abnormal Protein Band 1"?
Thanks Beacon staff!
Betsy, you said your lambda and kappa were both high. But, when I look at your values from your other post:
Free Kappa Lt Chains, S 14.46 mg/L
Free Lambda Lt Chains, S 11.72 mg/L
These numbers are in the normal range.
(normal Kappa is 3.3 to 19.4 mg/L and normal Lambda is 5.7 to 26.3 mg/L)
So, I would run with what Dr. Voorhees said earlier below (who is really the much-appreciated authority on your threads)
"Based on what you have reported, it does not appear that you have a monoclonal protein (i.e M spike or clonal free light chains). As such, I doubt that myeloma, amyloidosis or other clonal plasma cell disease is at play. I would keep your appointment with your Hematologist-Oncologist, though, to review the tests, as sometimes important details are missed in this forum. A good start, though. Based on your symptoms and labs, a rheumatologic process seems highly plausible. Further work-up is definitely necessary".
Betsy, you said your lambda and kappa were both high. But, when I look at your values from your other post:
Free Kappa Lt Chains, S 14.46 mg/L
Free Lambda Lt Chains, S 11.72 mg/L
These numbers are in the normal range.
(normal Kappa is 3.3 to 19.4 mg/L and normal Lambda is 5.7 to 26.3 mg/L)
So, I would run with what Dr. Voorhees said earlier below (who is really the much-appreciated authority on your threads)
"Based on what you have reported, it does not appear that you have a monoclonal protein (i.e M spike or clonal free light chains). As such, I doubt that myeloma, amyloidosis or other clonal plasma cell disease is at play. I would keep your appointment with your Hematologist-Oncologist, though, to review the tests, as sometimes important details are missed in this forum. A good start, though. Based on your symptoms and labs, a rheumatologic process seems highly plausible. Further work-up is definitely necessary".
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is "Abnormal Protein Band 1"?
Thanks Beacon Staff for all the wonderful things you do.
Hi Multibilly, thanks again for looking in to my posts and all your kindness.
Those tests results that I posted before were done at the end of last year and at the beginning of this year and I did not post all the results of the Urine Protein Electrophoresis that were done at the same time and shows.
ABNORMAL PROTEIN BAND 1 mg/dl see note
No M-Spike detected
The protein fractions are too small to quantitate.
So I was wondering what is ABNORMAL PROTEIN BAND 1, because like I said before I got that same result for the 3rd time last Month and I forgot to posted before.
Also I was talking about the complete kappa / lambda light chains in serum. Not the free light chains because as you said it have been OK.
Hi Multibilly, thanks again for looking in to my posts and all your kindness.
Those tests results that I posted before were done at the end of last year and at the beginning of this year and I did not post all the results of the Urine Protein Electrophoresis that were done at the same time and shows.
ABNORMAL PROTEIN BAND 1 mg/dl see note
No M-Spike detected
The protein fractions are too small to quantitate.
So I was wondering what is ABNORMAL PROTEIN BAND 1, because like I said before I got that same result for the 3rd time last Month and I forgot to posted before.
Also I was talking about the complete kappa / lambda light chains in serum. Not the free light chains because as you said it have been OK.
Re: What is "Abnormal Protein Band 1"?
Betsy,
OK, so I think I see where there is some confusion on your serum kappa and lambda free light chain tests.
In one of your earlier posts, you stated your results were as follows:
Kappa 298 mg/dL High range 74-295 ( these ranges are different that the ones in the other Lab).
Lamda 165 mg/dL High range 32-156
Kappa/Lambda Ratio 1.8
These appear to be the results of a Quest Diagnostics serum free light chain lab test.
http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=59162N&labCode=SJC
The serum free light chain test that multiple myeloma patients usually get is the patented Freelite Serum Free Light Assay. In fact, as far as I know, this is the only FDA approved free light assay test.
http://www.mlo-online.com/articles/200907/serum-free-light-chain-assays-detecting-plasma-cell-disorders.php
“…So far, the product, Freelite, is the only Food and Drug Administration (FDA) approved FLC assay on the market, although a similar product manufactured by an Italian company is being used in a few European countries to test urine samples. New guidelines in the United States, however, specifically recommend the use of FLC serum tests for diagnosis.”
In any case, it seems like you need to close the loop with your doc on these questions. Good luck sorting this out.
OK, so I think I see where there is some confusion on your serum kappa and lambda free light chain tests.
In one of your earlier posts, you stated your results were as follows:
Kappa 298 mg/dL High range 74-295 ( these ranges are different that the ones in the other Lab).
Lamda 165 mg/dL High range 32-156
Kappa/Lambda Ratio 1.8
These appear to be the results of a Quest Diagnostics serum free light chain lab test.
http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=59162N&labCode=SJC
The serum free light chain test that multiple myeloma patients usually get is the patented Freelite Serum Free Light Assay. In fact, as far as I know, this is the only FDA approved free light assay test.
http://www.mlo-online.com/articles/200907/serum-free-light-chain-assays-detecting-plasma-cell-disorders.php
“…So far, the product, Freelite, is the only Food and Drug Administration (FDA) approved FLC assay on the market, although a similar product manufactured by an Italian company is being used in a few European countries to test urine samples. New guidelines in the United States, however, specifically recommend the use of FLC serum tests for diagnosis.”
In any case, it seems like you need to close the loop with your doc on these questions. Good luck sorting this out.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is "Abnormal Protein Band 1"?
Hello everyone!!!
Hi Multibilly, I’m sorry if I don’t explain my self very well, remember I’m very confused about all these tests.
The first time that I had Protein Electrophoresis done was in September of last year (just in serum), then in November 2013 for the 2nd time, and the 24 Hour Urine for the first time.(Some of the results were posted when I came in to the Forum).
In January 2014 the new doctor repeated the tests and gave me the referral to the oncologist / hematologist who then got those results and prescribed some more tests in a period of 6 months. (Two set of tests in three visits, doctor did not repeat some of the tests, but she added some others -- a lot of labs!!!).
Some of the results (not everything because it will be too much):
Protein Electrophoresis and Kappa/Lambda Light Chains, Serum:
Protein, total 7.2 g/dl Reference range 6.1-8.1
Albumin 3.5 g/dL - Reference Range 3.5-4.7
Alpha-1-Globulin 0.2 g/dL Reference Range 0.1-0.3
Alpha-2-Globulin 0.7 g/dL Reference Range 0.5-1.0
Beta Globulins 1.4 g/dl High Reference Range 0.8-1.3
Gamma Globulins 1.3 g/dL Reference Range 0.6-1.6
Interpretation:
“Two faint bands in gamma region” which may represent a monoclonal gammopathy. Suggest immunofixation if clinically indicated and not already ordered.
Kappa 298 mg/dL HIGH (Reference range 74-295).
Lamda 165 mg/dL HIGH (Reference range 32-156).
Kappa/Lambda Ratio 1.8 (Reference range 1.3-2.7).
Calcium 9.9 mg/dl
GFR - 75 ml/min/1.73m2 - Reference Range >OR=60
Protein Electrophoresis 24 Hour Urine
Total Protein 24 hour Urine 200 mg/24h HIGH Reference Range <150
Protein/Creatinine Ratio 179 mg/g creat HIGH Reference Range < OR=84
Creatinine 24 hour urine 1.12 g/24 h Reference Range 0.63-2.50
M-Spike Not Observed
Random Urine Protein Electrophoresis:
Protein/Creatinine Ratio 62 mg/g creat Reference range 21-161
Protein Total 8 mg/dL Reference Range 5-24
Creatinine 129.3 mg/dL Reference range 20-320
“ABNORMAL PROTEIN BAND 1” mg/dl see note No M-Spike detected The protein fractions are too small to quantitate.
In February 2014
Beta 2 microgobulin, serum was 2.00 mg/L* (no range).
Albumin 3.9 g/dL - Reference Range 3.5-4.7
GFR - 71 ml/min/1.73m2 - Reference Range >OR=60
Protein Total 7.4 g/dL – Reference range 6.1-8.1
In June 2014
Beta 2 microgobulin, Serum was 2.30 mg/L < OR= 2.51.
Albumin 3.5 g/dL - Reference Range 3.5-4.7
GFR - 75 ml/min/1.73m2 - Reference Range >OR=60
Protein Total 7.8 g/dL – Reference range 6.1-8.1
Random Urine Protein Electrophoresis:
Protein / Creatinine Ratio 293 HIGH mg/g creat Reference range 21-161
Protein Total 8 mg/dL Reference Range 5-24
Creatinine 27.3 mg/dL Reference range 20-320
“ABNORMAL PROTEIN BAND 1” mg/dl see note No M-Spike detected The protein fractions are too small to quantitate.
I hope this is not more confusing!!!
Hi Multibilly, I’m sorry if I don’t explain my self very well, remember I’m very confused about all these tests.
The first time that I had Protein Electrophoresis done was in September of last year (just in serum), then in November 2013 for the 2nd time, and the 24 Hour Urine for the first time.(Some of the results were posted when I came in to the Forum).
In January 2014 the new doctor repeated the tests and gave me the referral to the oncologist / hematologist who then got those results and prescribed some more tests in a period of 6 months. (Two set of tests in three visits, doctor did not repeat some of the tests, but she added some others -- a lot of labs!!!).
Some of the results (not everything because it will be too much):
Protein Electrophoresis and Kappa/Lambda Light Chains, Serum:
Protein, total 7.2 g/dl Reference range 6.1-8.1
Albumin 3.5 g/dL - Reference Range 3.5-4.7
Alpha-1-Globulin 0.2 g/dL Reference Range 0.1-0.3
Alpha-2-Globulin 0.7 g/dL Reference Range 0.5-1.0
Beta Globulins 1.4 g/dl High Reference Range 0.8-1.3
Gamma Globulins 1.3 g/dL Reference Range 0.6-1.6
Interpretation:
“Two faint bands in gamma region” which may represent a monoclonal gammopathy. Suggest immunofixation if clinically indicated and not already ordered.
Kappa 298 mg/dL HIGH (Reference range 74-295).
Lamda 165 mg/dL HIGH (Reference range 32-156).
Kappa/Lambda Ratio 1.8 (Reference range 1.3-2.7).
Calcium 9.9 mg/dl
GFR - 75 ml/min/1.73m2 - Reference Range >OR=60
Protein Electrophoresis 24 Hour Urine
Total Protein 24 hour Urine 200 mg/24h HIGH Reference Range <150
Protein/Creatinine Ratio 179 mg/g creat HIGH Reference Range < OR=84
Creatinine 24 hour urine 1.12 g/24 h Reference Range 0.63-2.50
M-Spike Not Observed
Random Urine Protein Electrophoresis:
Protein/Creatinine Ratio 62 mg/g creat Reference range 21-161
Protein Total 8 mg/dL Reference Range 5-24
Creatinine 129.3 mg/dL Reference range 20-320
“ABNORMAL PROTEIN BAND 1” mg/dl see note No M-Spike detected The protein fractions are too small to quantitate.
In February 2014
Beta 2 microgobulin, serum was 2.00 mg/L* (no range).
Albumin 3.9 g/dL - Reference Range 3.5-4.7
GFR - 71 ml/min/1.73m2 - Reference Range >OR=60
Protein Total 7.4 g/dL – Reference range 6.1-8.1
In June 2014
Beta 2 microgobulin, Serum was 2.30 mg/L < OR= 2.51.
Albumin 3.5 g/dL - Reference Range 3.5-4.7
GFR - 75 ml/min/1.73m2 - Reference Range >OR=60
Protein Total 7.8 g/dL – Reference range 6.1-8.1
Random Urine Protein Electrophoresis:
Protein / Creatinine Ratio 293 HIGH mg/g creat Reference range 21-161
Protein Total 8 mg/dL Reference Range 5-24
Creatinine 27.3 mg/dL Reference range 20-320
“ABNORMAL PROTEIN BAND 1” mg/dl see note No M-Spike detected The protein fractions are too small to quantitate.
I hope this is not more confusing!!!
Re: What is "Abnormal Protein Band 1"?
So, yes, this can all be very confusing.
Again, I'm not a doc, but based on just what you've posted here for your June results, I don't think that would change what Dr. Voorhees said earlier.
In June did they do any of the following tests?
1. Serum Immunofixation - This will tell you very accurately if any monoclonal protein is present in your blood, but it doesn't tell you what the quantity is. The Serum Protein Electrophoresis, aka SPEP (whose results you include here from June) attempts to measure (quantitate) the amount of monoclonal protein. In your case, the lab result is telling you that they can't see enough to measure any, which is what you want. I wouldn't get hung up on trying to understand which specific bands the "Abnormal Protein Band 1" is looking at in your SPEP.
2. Freelite (Serum Free Light Chain) Assay - This will measure your serum lambda and kappa free light chains using the "standard" test for measuring these kinds of proteins.
In any case, I'm pretty sure that your doc will also say that you've got nothing to worry about with regard to having a monoclonal gammopathy.
To be sure, you can always just call up the doc's office and ask if you can talk to the doc or his/her nurse (the nurse which assists the oncologist / hematologist is usually an invaluable source of information and can typically help you out. If you don't have a relationship with that person, it's good to develop one).
You can also simply ask for a copy of the doctor's writeup from your last visit to see what the doc said. Or simply wait until you see the doc again.
Hope this helps.
Again, I'm not a doc, but based on just what you've posted here for your June results, I don't think that would change what Dr. Voorhees said earlier.
In June did they do any of the following tests?
1. Serum Immunofixation - This will tell you very accurately if any monoclonal protein is present in your blood, but it doesn't tell you what the quantity is. The Serum Protein Electrophoresis, aka SPEP (whose results you include here from June) attempts to measure (quantitate) the amount of monoclonal protein. In your case, the lab result is telling you that they can't see enough to measure any, which is what you want. I wouldn't get hung up on trying to understand which specific bands the "Abnormal Protein Band 1" is looking at in your SPEP.
2. Freelite (Serum Free Light Chain) Assay - This will measure your serum lambda and kappa free light chains using the "standard" test for measuring these kinds of proteins.
In any case, I'm pretty sure that your doc will also say that you've got nothing to worry about with regard to having a monoclonal gammopathy.
To be sure, you can always just call up the doc's office and ask if you can talk to the doc or his/her nurse (the nurse which assists the oncologist / hematologist is usually an invaluable source of information and can typically help you out. If you don't have a relationship with that person, it's good to develop one).
You can also simply ask for a copy of the doctor's writeup from your last visit to see what the doc said. Or simply wait until you see the doc again.
Hope this helps.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is "Abnormal Protein Band 1"?
Thank you Multibilly,for the explanation and the links. You have been a great help.
About the others tests that you mention, no that I know of. When I requested the copies from the record department in June, I just got those and the rest of regular CBC and Metabolic panel. I also got the bone survey result:
Impression:
Desgenerative spondylosis of the cervical, thoracic and lumbar spine is noted. No compression fracture lesion of the ppine noted. No evidence of bony destructive lytic lesion.
About the others tests that you mention, no that I know of. When I requested the copies from the record department in June, I just got those and the rest of regular CBC and Metabolic panel. I also got the bone survey result:
Impression:
Desgenerative spondylosis of the cervical, thoracic and lumbar spine is noted. No compression fracture lesion of the ppine noted. No evidence of bony destructive lytic lesion.
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