Smoldering Myeloma with Rising M-spike and Falling FLC's

Posted by judka @judka, 4 days ago

I was diagnosed with low-risk Smoldering Myeloma IGG Lambda in 2023. CBC has stayed within normal range, but M-spike has been slowly rising. My bone marrow transplant showed an infiltration of M protein of 10 - 20% with no gene abnormalities or deletions. FLC's are within normal range as is FLC ratio. So here's my question: My last lab work was similar to the one before it with two exceptions: M-spike was slightly higher - 2.91 g/dL - and FLCs were significantly lower - about a 40% drop from the last test. My research on this indicates that this is very unusual. Without treatment, FLC's tend to rise together with the M-spike. This test was taken over two weeks ago and I haven't heard from my doctor, nor have I been able to reach him. Does anyone know what this means? Has anyone had a similar experience?

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judka | @judka | 4 days ago

Correction: I didn't have a bone marrow transplant - I meant biopsy.

2121 | @leslie2121 | 4 days ago

My only thought is FLCs can be inflammation or autoimmune related? Has there been any change in your general health?
Hopefully your doctor will clarify.

sallik74 | @sallik74 | 4 days ago

Try putting this into chatGPT. It's a free app.
It has helped me tremendously.
I am low risk SMM go for my 3 month bloodwork the 19th.
Let's keep in touch since we both are low risk SMM.

edl75 | @edl75 | 4 days ago

My FLC numbers rise and fall significantly but dr convinced that’s do to inflammation as I have other autoimmune diseases. My ratio fluctuates also but always close to normal. Per my previous oncologist the M protein spike number and the FLC ratio are the critical numbers to watch not the individual FLC numbers. Good luck

judka | @judka | 4 days ago

In reply to @leslie2121 "My only thought is FLCs can be inflammation or autoimmune related? Has there been any change..." + (show)

Thanks for the input. I think I'm otherwise healthy, although there is always the possibility of inflammation somewhere - hopefully temporary!

judka | @judka | 4 days ago

In reply to @sallik74 "Try putting this into chatGPT. It's a free app. It has helped me tremendously. I am..." + (show)

That was great advice. ChatGPT gave me more information - and in a clearer format - than I was able to glean in over two years of searching the internet. It was somewhat reassuring - but definitely something that I need to address with my doctor. Does anyone else have a doctor who doesn't return phone calls?(called him a week ago).

judka | @judka | 4 days ago

In reply to @edl75 "My FLC numbers rise and fall significantly but dr convinced that’s do to inflammation as I..." + (show)

My doctor is not concerned with M-spike rising - even very high - unless accompanied by CRAB symptoms. My FLC numbers have always been pretty consistent, until this last blood test. But even though quite low, they are still within the normal range. I wonder whether the doctor even looks at previous tests for comparison if the FLC number is not flagged!

edl75 | @edl75 | 4 days ago

The actual FLC numbers vary so widely do to inflammation the ratio is the critical numbers. Interesting your dr not concerned about M spike that’s the #1 number my oncologist watches. I just started with MGUS a year ago and he checks every 3 months. Been consistently at .6 to .8. He doesn’t want to see any sudden increases or see it reach 3.0. I am 75 have NHL plus a rare autoimmune disease but fortunately still able to live my life. Good luck

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