Dear Cathy, I’m sorry that as yet no one has responded to your post. I hope you don’t mind me replying, my name is Ellen and I am one of the Myeloma Information Specialists at Myeloma UK.
An increase in the paraprotein reading can be alarming and the concern is that it may indicate that the myeloma is becoming active again. That said, many haematologists wouldn’t necessarily rush into retreating anyone whose paraprotein had risen and most will not make any decisions based on the paraprotein level alone. What doctors look at is the trend over a period of time. Doctors will take other factors into account and a rise in the paraprotein may prompt them to order other investigations such as additional blood tests a bone marrow biopsy or new X-rays. They would also take into account how well the patient is feeling in general and if there were any new or increased symptoms, such as pain or fatigue.
Any relapse would be managed on an individual basis taking into account previous treatments, the response and how well any treatment was tolerated. Generally in the UK patients at first relapse are offered treatment with the drug Velcade but there may be other options and this of course would depend on the individual situation.
So to summarise:
- Treatment may not begin again until there is evidence that the myeloma is beginning to cause problems in other areas such as the bones, the normal blood levels or the immune system.
- Your husband’s haematologist may order further tests to determine if he is indeed relapsing.
- Any relapse would be managed on an individual basis
I hope this has been of some help, but if you have any further questions, or would like to talk things through, please feel free to call the Myeloma Infoline on 0800 980 3332 – I or one of my colleagues can clarify things for you further. Alternately you can email directly to askthenurse@myeloma.org.uk
With best wishes
Ellen
