Month: October 2013

Analysis of the immune system of multiple myeloma patients achieving long-term disease control

The article is called “Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry.” It makes me think they mean long-term disease control was achieved by flow cytometry. That would be pretty awesome. They really mean that the analysis was done using MFC.

Highlights (determined by me)

Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance.

My comments: How can the monoclonal gammopathy be characterized as being of undetermined significance, when the pt has had MM? Obviously, there is a significance. I’m just picking. I know what they mean. It’s good to see that they’re asserting that complete response is not required. I have never had that. I think people put too much emphasis on it.

In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes favoring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance.

My Comments: None, really. I just like the word constellation. :) Dr. Peterson used to use that word a lot.

Despite the fact that until recently MM was considered incurable, the introduction of high dose therapy/autologous stem cell transplantation and novel drugs has made it possible for a small fraction of patients to attain long-term (≥5 years) disease control even in the absence of a complete response, after reverting to having an MGUS-like profile. The underlying mechanisms leading to disease suppression in these patients are largely unknown, although immune surveillance has been hypothesized to play a critical role.

My Comments: This is me, in a nutshell. The small fraction.

Test results from September 11, 2013

These are the latest test results.

25 mg/dL (60-263)
411 mg/dL (768-1632)
891 mg/dL (68-378)

FLC with ratio
Kappa: 0.15 mg/dL (0.33-1.94)
Lambda: 2.60 mg/dL (0.57-2.63)
K/L free ratio: 0.06 (0.26-1.65)

CBC w/differential

WBC 6.6 4.5-11.0 x(10)3/microL
Lymphocytes % 31.3 20.5-51.1 %
Monocytes % 6.0 1.7-9.3 %
Granulocytes % 62.7 42.2-75.2 %
Lymphocytes # 2.1 1.5-5.0 x(10)3/microL
Monocytes # 0.4 1.7-9.3 x(10)3/microL
Granulocytes # 4.1 1.4-6.5 x(10)3/microL
RBC 4.37 4.00-5.20 x(10)6/microL
Hemoglobin 13.3 12.0-16.0 mg/dL
Hematocrit 40.9 36.0-46.0 %
MCV 93.4 80.0-100.0 fL
MCH 30.3 26.0-34.0 pg
MCHC 32.5 31.0-37.0 mg/dL
RDW 13.4 11.6-13.7 %
Platelets 162 150-440 x(10)3/microL
MPV 7.2 7.0-10.0 fL

Other stuff

Beta-2 microglobulin
1.6 mg/L  (Normal range is 1.1-2.4)


Serum Protein Electrophoresis

Total protein 6.7 6.0-8.5 gm/dL
Albumin 4.0 3.2-5.6 gm/dL
Alpha-1-globulin 0.2 0.1-0.4 gm/dL
Alpha-2-globulin 0.5 0.4-1.2 gm/dL
Beta globulin 1.1 0.6-1.3 gm/dL
Gamma globulin 1.0 0.5-1.6 gm/dL
M-spike 0.3 gm/dL
Globulin, total 2.7 2.0-4.5 gm/dL
A/G ratio 1.5 0.7-2.0


Comprehensive Metabolic Panel

Sodium 139 136-144 mmol/L
Potassium 4.0 3.6-5.1 mmol/L
Chloride 107 101-111 mmol/L
CO2 23 22-32 mmol/L
Random glucose 106 65-140 mg/dL
BUN 12 8-26 mg/dL
Creatinine 0.72 0.4-1.0 mg/dL
eGFR >60 2
Calcium 9.0 8.9-10.3 mg/dL
Albumin 3.9 3.5-5.0 gm/dL
Protein, total 7.2 6.5-8.1 gm/dL
Alkaline Phosphatase 95 50-86 Units/L
ALT (SGPT) 51 14-54 Units/L
AST (SGOT) 34 10-41 Units/L
Bilirubin, total 0.7 0.4-2.0 mg/dL
Anion gap 8.5