Mixed Results

Pomalyst Study Cycle 69

Thursday, June 27, 2013:

M-Spike and IgG:

IgG went up 21% in the last 28 days, from 1070 mg/dL last month to 1300 this month. M-spike comes in later but usually follows IgG closely, so I left Mayo for home assuming that the cancer markers, with an up-and-down history, were going up again. After the 90-minute drive home, though, I checked into Mayo Clinic on line and M-spike had a value of 1.0 g/dL (1000 mg/dL), unchanged from the previous cycle. How could that be?

IgG is the sum of the "bad" IgG, the useless monoclonal proteins produced by the myeloma cells and measured by the M-spike, and the "good" IgG, which is an essential part of the immune system. Assuming that error in the the tests themselves could not be large enough to produce this discrepancy between IgG and M-spike, the best explanation is that the "good" IgG is up this time, possibly because of a recent sinus infection. I'll go with that for today, and we'll see what happens next month.

Light Chains:

In recent months both the Lambda and the Kappa light chains have been creeping upward. Last month both were above their reference ranges, for the first time ever. Today, though, both are down a little, each almost exactly at the top of its reference range. I guess I like that better. The Kappa/Lambda ratio is smack in the middle of its reference range, which is a good thing. Whatever - I don't know what to think about the creeping light chains.


Mayo performed an ECG on me this time, as they do every third month, and as always the doctor who reported on the ECG complained about the low heart rate of 44 beats per minute, but nothing else: "Marked sinus bradycardia, otherwise normal ECG." The heart, to quote a Timex advertisement, just "takes a lickin' and keeps on tickin'." I wonder how high it goes these days when I run. I should see if my 11-year-old heart-rate monitor still works after being shelved for years.

Most-Recent Test Results:

Test    Apr 04    May 02    May 30    Jun 27     Remarks
M-spike g/dL 1.1 1.1 1.0 1.0 \ Tumor marker
IgG mg/dL 1230 1060 1070 1300 / Tumor marker
Lambda mg/dL 3.30 2.89 3.72 2.61 L free light chains
Kappa mg/dL 1.80 1.94 2.00 1.95 K free light chains
Ratio 0.26-1.65 0.56 0.67 0.54 0.75 Kappa / Lambda
Calcium mg/dL 10.0 9.4 9.3 9.5 OK
Creatinine mg/dL 1.5 1.2 1.3 1.2 Kidney, OK
HGB g/dL 15.5 14.9 14.8 15.1 Hemoglobin, OK
RBC M/uL 4.53 4.40 4.33 4.38 Red cells, lowish
WBC K/uL 5.2 4.5 4.8 5.1 White cells, OK
ANC K/uL 2.2 1.5 2.7 2.4 Neutrophils, OK

Related Links:

My Myeloma     A discussion of my myeloma, not very technical.
My Treatment History Not technical.
My Test Charts Graphic displays of several key test results over time.
My Test Result Table Somewhat technical. Best with a wide browser window.
My Supplement Regimen With links to where I buy them.