I had blood drawn on 6/3, and got the results back today.

Test: Result (Normal Range)

IGG: 455 (600-1700)
IGM: 34 (35-290)
IGA: 466 (40-400)

This is from last time, so you can see there’s not much change!

IGG: 466 (600-1700)
IGM: 31 (35-290)
IGA: 408 (40-400)

I found a new web site that I’m still checking out.  It has details about lab tests and other info.
http://www.clinlabnavigator.com/

Anyway, the doc says I’m still smoldering!

I was at Five Points Pet Resort a couple of weeks ago, where this green-winged macaw engaged us.  He has a lot of personality!

Here are my latest results.

Specific Proteins

Test Name    Result       AB    Normal Range   Units
IGG          466          L     600-1700       MG/DL
IGM          31           L     35-290         MG/DL
IGA          408          H     40-400         MG/DL

Electrophoresis

The SPE pattern demonstrates two bands of restricted mobility in the gamma region.

Immunofix, Serum

Monoclonal component typed as IgA Lambda. Concentration of monoclonal protein determined by serum protein electrophoresis is 0.4 g/dL.
Monoclonal component typed as IgA Lambda. Concentration of monoclonal protein determined by serum protein electrophoresis is 0.3 g/dL.
*Suggestive of a monoclonal component typed as IgG Kappa. Concentration of monoclonal protein is too low to accurately quantify.

* This is new! Previously, I’ve only ever had just two m-spikes. That’s not enough?  I vaguely remember seeing this on one other report, so maybe it’s something that comes and goes.  In any case, it’s not enough to measure, so I’m not alarmed.

Serum Free Light Chain Assay

Test Name                  Result     AB  Normal Range    Units
Kappa Free, Serum          0.1380     L   0.33-1.94       mg/dL
Lambda Free, Serum         1.24           0.57-2.63       mg/dL
K/L FLC Ratio              0.1113     L   0.26-1.65       mg/dL

Still, no myeloma treatment for over two years.

GENLAB Immunology: Final    06/01/2009 15:03

IMMUNOGLOBULIN PROFILE
                                                             Reference
  IMMUNOGLOBULIN G                  *410         mg/dL       [588-1573]
          TEST REPEATED TO CONFIRM
            NOTE:  African-American reference ranges differ slightly from
                   those listed.  Please call the Immunology Lab at 684-6939
                   for race specific ranges.
  IMMUNOGLOBULIN A                  *432         mg/dL       [46-287]
          TEST REPEATED TO CONFIRM
  IMMUNOGLOBULIN M                  *26          mg/dL       [57-237]
  IMMUNOGLOBULIN E                   30          IU/mL       [4-269]

Lab Report: Final    06/01/2009 14:36

SERUM PROTEIN ELECTROPHORESIS
                                                             Reference
  SPE INTERP
   COMPARED TO 2/10/09, NO SIGNIFICANT CHANGE IN PREVIOUSLY
  CHARACTERIZED (2) IGA-LAMBDA COMPONENTS FROM 0.21 TO 0.25 AND
  0.14 TO 0.19 G/DL.
  "I have personally performed the interpretation".  Dr. S. Pizzo, MD,PhD

  SPE TOTAL PROTEIN                  6.8         g/dL        [6.0-8.0]
  SPE ALBUMIN %                      65.6        %
  SPE ALBUMIN                        4.46        g/dL        [3.97-5.34]
  SPE ALPHA 1 %                      2.9         %
  SPE ALPHA 1                        0.20        g/dL        [0.11-0.32]
  SPE ALPHA 2 %                      10.5        %
  SPE ALPHA 2                        0.71        g/dL        [0.40-0.88]
  SPE BETA %                         11.3        %
  SPE BETA                           0.77        g/dL        [0.60-1.02]
  SPE GAMMA %                        9.7         %
  SPE GAMMA                          0.66        g/dL        [0.53-1.37]
  SPE M-SPIKE 1 %                    3.7         %
  SPE M-SPIKE 1                      0.25        g/dL
  SPE M-SPIKE 2 %                    2.8         %
  SPE M-SPIKE 2                      0.19        g/dL

I don’t have a lot to blog about here because my myeloma has been stable since last fall. There’s not much there at all.  If you don’t have myeloma, I have only a little bit more than you do.

These labs were done 12/08/2008


IFE SERUM
(2) MONOCLONAL IgA-LAMBDAS DETECTED BY IFE.
SPE M-SPIKE 1                      0.17        g/dL
SPE M-SPIKE 2                      0.12        g/dL

IG FREE LIGHT CHAINS SERUM
                                                         Reference
  IG FREE LIGHT CHAIN KAPPA         *0.16mg/dL       [0.33-1.94]
  IG FREE LIGHT CHAIN LAMBDA         1.85mg/dL       [0.57-2.63]
  IG FLC KAPPA/LAMBDA RATIO         *0.09            [0.26-1.65]

IMMUNOGLOBULIN PROFILE
IMMUNOGLOBULIN G                  *374mg/dL       [588-1573]
TEST REPEATED TO CONFIRM
IMMUNOGLOBULIN A                  *415mg/dL       [46-287]
TEST REPEATED TO CONFIRM
IMMUNOGLOBULIN M                  *31mg/dL       [57-237]
TEST REPEATED TO CONFIRM
IMMUNOGLOBULIN E                   13 IU/mL       [4-269]

On the mailing list we had a discussion about bone disease in MM.  Here’s what Nancy said about it. I hadn’t realized before that IgA patients are less prone to bone disease.  One of my doctors did tell me we’re more likely to have kidney involvement though.

Some people never have bone disease…that’s just the way their myeloma is; just as some people never have kidney problems. The names given to the variations of myeloma are not different. Patients with IgA myeloma are less likely to have bone disease than those with IgG myeloma…and those with IgG myeloma are less like than those with IgA myeloma (or Bence Jones myeloma) to have kidney problems.

Perhaps by “classic myeloma” they are referring to myeloma that is in the bone marrow…as opposed to extramedullary myeloma which is outside the bone marrow….rather than affecting the bones. However, about 80% of patients do have bone involvement, so it is the most common symptom of myeloma.

For more information about multiple myeloma, visit the IMF web site:
http://myeloma.org

This is a chart of my IgA values since before the SCT last summer.  I stopped Velcade and Doxil in July, 2007 and the SCT took place at the end of August. This is quantitative serum IgA in mg/dL. The test on 10/11/2007 was the first one I had after stem cell transplant.

I’ve never once regretted having the SCT, and only wish I had done it earlier. In my case, nothing was keeping the mm under control for very long. The SCT has allowed me to be off treatment for 10 months now, which is a long time for me.

Duke allows me to look at my lab results online, and I’ve been waiting to see what my m-spikes are (I have two).  So far, they’ve stayed under 0.5 g/dL when added together.  That’s so much better than the 3.4 g/dL they were back in 2003.

IgA values in mg/dL

The reference range at Duke’s lab for IgA is 46 – 287.