Could someone please tell me which number is the M-spike on the electrophoresis report? And, if that is indeed where the number is found, is it on the urine or blood electrophoresis?
Thank you.
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Re: Which number is the M-spike on the electrophoresis repor
Hi Husker!
Wolverine here!!!
When you look at report you may see acronyms.
One will say UPEP that is Urine protein eletrophoresis
The other will say SPEP that is SERUM protein electrophoresis.
You want to look at the SPEP number as it is the serum number they call the M spike.
They call it a spike cause if you saw the tape of it, it would like an EKG does with waves that spike up and down.
Your report does not send you the visual, you just get quantatative number,
That correlates with when the 'spike' was seen on the tape.
And that can have a range from less than one to more than 5.
Hope this helps.
Go Blue!!
Wolverine here!!!
When you look at report you may see acronyms.
One will say UPEP that is Urine protein eletrophoresis
The other will say SPEP that is SERUM protein electrophoresis.
You want to look at the SPEP number as it is the serum number they call the M spike.
They call it a spike cause if you saw the tape of it, it would like an EKG does with waves that spike up and down.
Your report does not send you the visual, you just get quantatative number,
That correlates with when the 'spike' was seen on the tape.
And that can have a range from less than one to more than 5.
Hope this helps.
Go Blue!!
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: Which number is the M-spike on the electrophoresis repor
Thanks for your reply! Actually, my husband's electrophoresis does show the visual, or the graph, as we have come to call it. There are so many numbers on the page also, it's hard for me to determine which number is the m-spike. Some of the info listed includes "Fractions", and under that title, it lists Albumin, Alpha1, Alpha 2, Beta, and Gamma. Then each of those have a % and a g/dl number listed. There is also a A/G number and a TP number. Needless to say, I'm confused! 
Re: Which number is the M-spike on the electrophoresis repor
LOL LOL...love the emoticon.
OK, since I can't see what you see...gonna give my best shot at guessing what you may be 'seeing' and some tips that may help in sorting out what you are reading.
First thing I do. is look for reference range which gives you what the NORMALS are for each
item they are reporting. Typically, they highlight in someway with a raised H or L (high/low) or they have an asterisk, or A for abnormal next to YOUR values..something so you immediately can know, those numbers are not norms. The reference range is usually listed to the far right of what YOUR number is.
That helps get a handle on what is within NORM and which you are not having issues with. The docs like it quick and dirty, too!!..they focus in on the abnormals immediately.
Personally, I haven't ever seen the graph! of the M-spike..cause the report just gave a number.
Your report has to as well, so look for SPEP and read that value. You should see a norm reference to the right of that value to help you judge if you are within a normal range or not. Caution! the norms are for tests done in lab you went to and should not be compared to others who did not have results from THAT lab.
ALBUMIN...it is the most prevalent blood protein. multiple myeloma abnormal cells crowd it out, so typically you may see a low albumin..if it is not low, then the disease is considered not as severe. Look at the number they give, and again look on far right and find reference number from your lab. Compare are you high/low, (right under cut off), or are you in the norm?
Good info here:
https://myelomabeacon.org/news/2009/11/29/serum-albumin-levels-indicate-severity-of-multiple-myeloma/
The percent is being given so that ratios can be determined of the presence of each of those globulin proteins (i.e. both alphas, beta, and gamma). Typically the Beta microglubin is the one you want to hone in on. It is looked at in percent of relative to albumin...because again..it is that microglubin that is crowding out the albumin and that is lowering albumin number in many multiple myeloma patients.
I am guessing that TP is total protein (denominator) and A/G is albumin to globulin ratio. Typically a low A/G ratio is seen in multiple myeloma... again all of these are to show what percent of these cells are out of line with the normal percent of protein in blood along with albumin and the immunoglobulins (alpha/beta/gamma/kappa/lambda). IOW's what percent of these cells are present vs. normal plasma cells.
Now for the fractions...if you are even reading this far...all I can say is...you are a trooper..YGG!!
Fractions are typically given to show the light chain ratio for kappa/lambda free chains. Long story short ...they should not be floating around free!! This ratio in conjunction with the SPEP are used most often to monitor disease progress. This article may help:
https://myelomabeacon.org/news/2009/01/22/scientists-develop-serum-immunoglobulin-free-light-chain-assay-develop-for-early-myeloma-diagnosis/
So, if I were you to start with..I would simply focus in on your kappa/lambda free chain ratio and your SPEP (Mspike) ...that will make a good start in terms of knowing the severity of disease.
The other most recent risk stratification they do is FISH, that tests for chromosomal or cytogenetic abnormalities and can be prognostic as well.
I hope my unseeing eyes, have been of some help.
Enjoy the GAME!!
Whip those SPARTANS!!
and WELCOME to the BIG TEN!!
OK, since I can't see what you see...gonna give my best shot at guessing what you may be 'seeing' and some tips that may help in sorting out what you are reading.
First thing I do. is look for reference range which gives you what the NORMALS are for each
item they are reporting. Typically, they highlight in someway with a raised H or L (high/low) or they have an asterisk, or A for abnormal next to YOUR values..something so you immediately can know, those numbers are not norms. The reference range is usually listed to the far right of what YOUR number is.
That helps get a handle on what is within NORM and which you are not having issues with. The docs like it quick and dirty, too!!..they focus in on the abnormals immediately.
Personally, I haven't ever seen the graph! of the M-spike..cause the report just gave a number.
Your report has to as well, so look for SPEP and read that value. You should see a norm reference to the right of that value to help you judge if you are within a normal range or not. Caution! the norms are for tests done in lab you went to and should not be compared to others who did not have results from THAT lab.
ALBUMIN...it is the most prevalent blood protein. multiple myeloma abnormal cells crowd it out, so typically you may see a low albumin..if it is not low, then the disease is considered not as severe. Look at the number they give, and again look on far right and find reference number from your lab. Compare are you high/low, (right under cut off), or are you in the norm?
Good info here:
https://myelomabeacon.org/news/2009/11/29/serum-albumin-levels-indicate-severity-of-multiple-myeloma/
The percent is being given so that ratios can be determined of the presence of each of those globulin proteins (i.e. both alphas, beta, and gamma). Typically the Beta microglubin is the one you want to hone in on. It is looked at in percent of relative to albumin...because again..it is that microglubin that is crowding out the albumin and that is lowering albumin number in many multiple myeloma patients.
I am guessing that TP is total protein (denominator) and A/G is albumin to globulin ratio. Typically a low A/G ratio is seen in multiple myeloma... again all of these are to show what percent of these cells are out of line with the normal percent of protein in blood along with albumin and the immunoglobulins (alpha/beta/gamma/kappa/lambda). IOW's what percent of these cells are present vs. normal plasma cells.
Now for the fractions...if you are even reading this far...all I can say is...you are a trooper..YGG!!
Fractions are typically given to show the light chain ratio for kappa/lambda free chains. Long story short ...they should not be floating around free!! This ratio in conjunction with the SPEP are used most often to monitor disease progress. This article may help:
https://myelomabeacon.org/news/2009/01/22/scientists-develop-serum-immunoglobulin-free-light-chain-assay-develop-for-early-myeloma-diagnosis/
So, if I were you to start with..I would simply focus in on your kappa/lambda free chain ratio and your SPEP (Mspike) ...that will make a good start in terms of knowing the severity of disease.
The other most recent risk stratification they do is FISH, that tests for chromosomal or cytogenetic abnormalities and can be prognostic as well.
I hope my unseeing eyes, have been of some help.
Enjoy the GAME!!
Whip those SPARTANS!!
and WELCOME to the BIG TEN!!
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: Which number is the M-spike on the electrophoresis repor
Wow! I'm amazed at all the info you are providing. Thanks so much! No where on the report do I see SPEP. The Albumin is at 66.4%, and 4.5g/dl, which is in the normal range of 3.8 - 5.0. The Beta is 9.8%, or 0.7, which is in the normal range of 0.5 - 1.0. I guess I should focus on the pathologist's interpretation, which says: "No monoclonal gammopathy noted on serum protein electrophoresis."
Thanks for the "welcome" to the Big 10! We certainly are enjoying today's game!!! Hubby and I are a bit surprised at how well the Huskers are playing today. Surprised, but PLEASED!
Thanks for the "welcome" to the Big 10! We certainly are enjoying today's game!!! Hubby and I are a bit surprised at how well the Huskers are playing today. Surprised, but PLEASED!
Re: Which number is the M-spike on the electrophoresis repor
Yes!!
..when report says...no monoclonal gammopathy noted on SPEP
You won the lottery for NOT having a SECRETORY protein multiple myeloma!!
YAY!!
However, you are not out of the woods...there is also a NON-SECRETORY multiple myeloma.
Other than you will need to follow the light chain ratios NOT... SPEP, I know little about non-secretory multiple myeloma, however.. you can throw out those GRAPHS and not be concerned with M spikes!!
Focus on light chain kappa/lambda ratios...OR the particular greek letter combo you have...gamma, etc
Also, you will need to look at the URINE...
UPEP since you may be excreting proteins via urine instead of them being in serum.
try these reference sources:
https://myelomabeacon.org/resources/2008/10/15/diagnosis/
https://myelomabeacon.org/headline/2011/10/21/nonsecretory-multiple-myeloma/
..when report says...no monoclonal gammopathy noted on SPEP
You won the lottery for NOT having a SECRETORY protein multiple myeloma!!
YAY!!
However, you are not out of the woods...there is also a NON-SECRETORY multiple myeloma.
Other than you will need to follow the light chain ratios NOT... SPEP, I know little about non-secretory multiple myeloma, however.. you can throw out those GRAPHS and not be concerned with M spikes!!
Focus on light chain kappa/lambda ratios...OR the particular greek letter combo you have...gamma, etc
Also, you will need to look at the URINE...
UPEP since you may be excreting proteins via urine instead of them being in serum.
try these reference sources:
https://myelomabeacon.org/resources/2008/10/15/diagnosis/
https://myelomabeacon.org/headline/2011/10/21/nonsecretory-multiple-myeloma/
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: Which number is the M-spike on the electrophoresis repor
As Suzierose indicated the SPEP will catch the majority of monoclonal paraproteins and is a good first screening test. Mine is always perfectly normal. However and unfortunately, I have light chain only myeloma (about 20% of myeloma patients) and light chains don't show in the SPEP. They show in FLC assays and 24 hour urine tests in the form of Bence Jones paraproteins. Strange but true. This is why it took my original doctor a couple months to diagnose me. I had no CRAB symptoms and the SPEP was normal. For true non-secretors, it is usually found, unfortunately, when a bone breaks or there is a renal issue. Myeloma really stinks...
-
terryl1 - Name: Terry
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 10, 2011
- Age at diagnosis: 49
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