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.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533663/

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.

IgM
25 mg/dL (60-263)
IgG
411 mg/dL (768-1632)
IgA
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