[concerned_daughterParticipant]

My mom was just excluded from an osteoporosis trial because it turns out the tests done for the trial revealed that something else caused her spine fractures (first revealed in an MRI scan and subsequent bone density test, after she experienced pain around ribs and back).

I quote from the test results: “The electrophoretogram reveals a monoclonal peak (28 g/L) in the beta region. Immunoglobulin quantitation shows immuneparesis. Immunofixation has been done to type the peak. A serum free light chain assay should be done, as it is required for further management of the patient. Other baseline investigations indicated: s-Calcium, s-Creatinine, FBC, u-BJP, radiographic bone survey.”

Elsewhere on the report it shows that the serum monoclonal peak was typed as IgA kappa. The result was flagged as High (26.30) compared to a reference of 0.70-3.50 g/L.

When she was called in to tell her she could no longer participate in the osteoporosis trial, she was told about the anomaly and the doctor referred her to a specialist for further tests, saying it could be malignant. However, either the doctor or the pathologists had hand written “Myeloma” on these test results.

Are these indicators enough to presume she has Myeloma (for me, I mean – I’m not going to tell her anything until she has been for further tests). But can I expect this result? I want to be prepared for it, especially as I’m about to leave for a 3-week overseas trip and might not be around when she gets diagnosed. She’s a widow and will be alone when I’m not here.

Oh, other tests results have revealed she is anemic. The doctor said B12, but now I’m not so sure. She has also mentioned thinking there was a problem with her kidneys. Something else that tested high was Lymphocyte (though I don’t know if this is relevant). Chemistry panel shows Calcium is within the normal range.

Could these results indicate anything besides Myeloma? Any input would be much appreciated!

[graham-cParticipant]

The priority issue is the potential malignancy and though a diagnosis of Myeloma is never good, it will help the hospital to understand the underlying cause and lead them to make further tests. To a greater or lesser extent a large proportion of the population will have these ‘clonal cells’ in their blood and whether they represent a risk is a combination of test results, investigations, current symptoms and opinion. The priority is always the conditions caused by Myeloma, as often people don’t realise they have it until they suffer an acute episode so the hospital have to treat both as well as determining whether to not it has affected any other organs.

I’m at the MGUS stage and do not receive treatment as there is no telling whether or not it will develop and where it may strike. The point is that Myeloma isn’t a good diagnosis to receive but there’s no telling what its implications are for any individual, and it affects people in many different ways – the bones and kidneys being two main areas.

I would have thought that Myeloma is quite likely but that diagnosis is actually helpful in understanding how she may be affected and what treatment she should receive. In any event the likelihood of a possible malignancy is what will receive priority.

 

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