Multiple Myeloma results

[jeapal23]

My husband for the last 10 year has MGUS,  in January he was getting back pain, doctors xrayed his back and told him it was just wear and tear.  Blood results were paraprotein   31%  in April it had gone to 38% and in May  had risen to 48% .  Doctor told him he had Myeloma,, ordered full body xrays and bone marrow, and told him he would strat treament on June 4th.  On Friday when he had the other test his paraprotein level had gone back down to 38%, doctor told him he may not need treatment.

Can you tell me why the drop in paraprotein in a 2 week period  ???   and when is Myeloma, myeloma

Jean

[jeapal23]

he has had further test and the results show that he has 13% plasma cells, from a bone marrow test, no bone lesions, kidney problems or aneamia.  so they have decided that he does not need treatment at the moment,  they are going to test him every month

[Fernando Roque, MD]

Hi.  Multiple myeloma is a malignancy involving plasma cells and B lymphocytes.  These are a type of white blood cell which produces immunoglobulins or antibodies.  Since the malignant plasma cells are clones of a single abnormal lymphocyte, they all produce the same kind of immunoglobulin in large quantities.  This over-produced immunoglobulin is what is called paraprotein or M-protein ("M" stands for monoclonal or myeloma).

Basically, multiple myeloma is diagnosed when the serum paraprotein exceeds a certain level (at least 30 grams/liter), or if malignant plasma cell clones are found in large enough numbers in the bone marrow (at least 10% of the total population of plasma cells).  Myeloma is further classified into "smoldering" or "active" types, depending on whether they produce symptoms (active) or not (smoldering).  Symptoms which indicate active disease include bone disease, increase in serum calcium, anemia, and renal dysfunction.

Since your husband's paraprotein levels are persistently greater than 30 (I'm assuming that the values you posted are not in percentages, but in grams/liter), these results are enough to diagnose him as having Myeloma.  His doctor might have decided to withhold treatment for now because your husband may just have smoldering or asymptomatic disease.  Observation in 3-6 month intervals is enough in this case.  Treatment is reserved for more advanced stages or symptomatic disease.

MGUS (monoclonal gammopathy of undetermined significance) is a condition where there is also an excess of paraprotein in the serum, but the levels usually are below 20 grams/liter.  

I hope the explanations help.