January 17, 2014

by kpw413

Today is ASCT +94. And no, the M-spike data did not come in yet. 😔

Wow, was I ever way too technical in my last posting. Let’s see if I can break it down. Myeloma is a cancer of the plasma cells. In the blood stream are all sorts of biological chemicals that make up our immune system, such as immunoglobulins that are divided into A, G, or M proteins. One of the typical hallmarks of myeloma is that the cancerous plasma cells typically produce only one of the proteins, most commonly the M protein. This is called a monoclonal protein because the cancerous plasma cells only produce


of the required immunoglobulins instead of all three, which is the reason for the mono in monoclonal protein. The clonal refers to the fact that the cancerous cells are simply reproducing one protein clone instead of the variety of proteins healthy plasma cells produce. This give rise to M-Spike referring to an abnormally high numbers of only one kind of proteins. This M-spike is supposed to be zero or none detected. At it worst, my M-spike was 2.3. This the one value I don’t have yet, but I expect that it is zero.

Here’s why. My oncologist, Warren, has always said that once my M-spike reached zero, he would then test for the other markers such as free light chains. Now the immunoglobulins are regularly tested for myeloma patients, but these are the heavy chain proteins – they are bigger. Most myeloma patients are divided into groups depending on which immunoglobulin they have in excess, A, G, or M. I have been a G, which is most common. My IgG (shorthand for immunoglobulin G) was over 3200 at it’s worst, an my others were low. Now all my immunoglobulins are below normal range. This will sort itself out and normal ranges will be achieved.

Back to the free light chains. These are another variety of proteins involved in the immune system. There are two primary types called kappa or lambda. And again, myeloma patients are typically one or the other, based on which one is in excess. For some patients, the only markers they have are whether they are kappa or lambda; they have no monoclonal protein. This does not mean that their myeloma is any less dangerous – it can still cause a lot of organ damage. The other things oncologists look it is the ratio of kappa to lambda. I am a kappa patient and my ratio of kappa to lambda was 16.03 (normal max of 2.65). Both of my light chains are now below range too, and my ratio is just a smidgen over the max at 2.75!

Back to what’s tested when. When the M-spike reaches zero, and the immunoglobulins are also in range, then doctors will test for free light chains because these are the last to come in range. Once the M-spike is zero and the immunoglobulins are in range, the a patient is considered to be in complete remission. Then a patient is tested for the free light chains, and if these are also now in range, the patient is considered to be in stringent complete remission. This is currently the best that a myeloma patient can hope for.

Well, because both my immunoglobulins are in range, and my free light chains are in range, it seems to me that my M-spike must also be in range. Therefore, concludes me, I must be in stringent complete remission. Has all this made it more understandable? If so you know why I say, Hallelujah! Praise be to God.

Thank you, Lord Jesus, for my healing, and thank you the healing received by others for whom we pray, Hirma, Berris, Nicola, Sylvia, Barbara, Frank, Donna, Irene, Brian, Kevin, Mike, and Joe.