Elevated AFP levels on tx

[dlr2007]

Hi Everyone,
I've been meaning to check in and update you all, but I wanted it to be with good news instead of a question. Things have going pretty well for my husband Rick. He has had Hep C genotyoe 1a for about 25 years. His low platelets and albumin suggested cirrhosis- he scored a 42 on a Fibroscan.

At his 1 month bloodwork, his viral load had dropped from 5.9 million to around 1000- his NP said she would've been happy with that at 2 months :) . His ALT/AST's were down from slightly elevated to very normal, and his platelets were OK, having gone from 128,000 to 70,000. The only thing was his red/white blood cells took a big hit. The NP put Rick on Procrit last week, when he went for his 2nd month of bloodwork.

Today we got a call from his NP- he spoke to the NP, not me, so the facts aren't very clear. However, the NP said his AFP is elevated- hubby "thinks" she said slightly elevated. She ordered an MRI to rule out cancer on July 22nd. I'm really worried about this. The strange thing is that Rick had slightly elevated AFP levels before tx- about 10.5. And his feet and hands are very swollen, but I read that can be from the Procrit.

I'm just anxious and wondering just what this means. If anyone has any advice, I would really appreciate it.
Thanks,
Dee

[CoWriter]

Here's what a lab results website says about the AFP-L3% test....

"An AFP-L3% may be ordered to help evaluate the risk of hepatocellular carcinoma when a patient has chronic liver disease. This new test, however, is not widely used and its ultimate clinical utility has yet to be established."

"With an AFP-L3%, the doctor receives both a total AFP result and the percentage of AFP that is L3."

"NOTE: This test has no single number that identifies an abnormal result. Your lab report should include a range of numbers that identifies what is expected for you based on your age, sex, and the method used in that laboratory."

"Both AFP and AFP-L3% concentrations can be elevated, and fluctuate, in patients with chronic hepatitis and cirrhosis. In these patients, a significant increase in AFP is more important than the actual numerical value of the test result."

(And your husband didn't have a "significant increase in AFP")


"Not every patient with increased AFP and AFP-L3% test results has cancer or will develop liver cancer. The AFP and AFP-L3% tests are not diagnostic; they are indicators. They must be used in conjunction with imaging studies to look for malignant tumors when monitoring the patient, or when a doctor suspects that a cancer is present. The tests can provide useful information, but they are not as specific or sensitive as doctors would wish. They should not be used to screen the general population for cancer."

http://www.labtestsonline.org/understanding/analytes/afp_tumor/test.html

Co

[dlr2007]

Thank you for your reply. I just spoke to Rick's NP and she said that they do a more specific test for tumors, called the AFP-L3 test, and it's supposed to come back less than 10 percent. Rick's came back at 28 percent. His regular AFP is only 10.4- that has barely risen from last year, when it was 9 or 10. I need to find out more about this AFP-L3 test and see what ranges are- probably up to 100 percent. Also, I'm anxious to know how accurate it is. Hopefully it's just one of those fancy new tests that is extrasensitive and this doesn't mean much. The NP said she's being very cautious, just in case they missed something. I'm scared anyway :( . Guess I'll start a new post of AFP-L3 test in case anyone has heard of it.

[HCA]

It's almost certainly nothing.
Highly elevated AFP is a (crude) marker for liver cancer-slightly elevated is not significant.