Multiple myeloma

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This is a question on behalf of my mother-in-law, who is 84 years old.  She has been suffering from chronic anaemia, loss of appetite, and pain in the back and shoulders.  Her specialist (in Kolkata, India) recommended a range of blood tests.  The latest set of tests have come back indicating IgG gamma markers in her blood.  Her platelet counts are low (115,000), there do not seem to be any abnormalities in her WBC, and her red blood cell markers appear to be by and large fine.  Her kidney function - as measured by plasma creatinine - seems fine too, although I think she needs some more detailed tests including perhaps a scan.  I am not sure if she has had a measurement of her calcium levels but her other salts are again normal (although her uric acid levels are high.)

Sorry for the lengthy preamble/summary but I would like to understand whether the existing of IgG gamma markers automatically means that her disease has progressed to myeloma, or whether it could be still at the MGUS or smouldering stages.  What needs to be known (the precise level of the markers, for example?) before such a determination can be made?  Is there a staging of myeloma that happens as in other types of cancers?

I know there are more invasive tests - such as a bone marrow biopsy - that might be needed, or a more detailed CAT, PET or MRI scan, but absent these, is there a way of reaching any kind of informal view based on blood tests alone.  

Any advice you could give would be very gratefully received.

  • Thanks for getting in touch and welcome to the Online Community. I hope you find it useful. My name’s Donna, I’m one of the cancer information nurse specialists on the Macmillan Support Line

    As a UK based charity, we are unable to advise on healthcare systems overseas. We are also unable to diagnose on this platform. It is important you speak to your mother-in-law’s healthcare team in India about any symptoms, blood tests or health concerns you may have.

    We can, however, suggest some areas of further information and support which you may find helpful.

    We have some information about MGUS and Myeloma on our website.

    Each year, about 1 out of 100 people with MGUS (1%) develop a related cancer, such as myeloma or lymphoma. However, most people with MGUS never develop a related cancer and do not need treatment. Doctors may do regular blood tests to monitor and check for any changes.

    Blood tests are an important way of diagnosing and monitoring blood conditions. However, other investigations may also be used to confirm a diagnosis.

    Cancer Research UK and Blood Cancer UK  may also have some relevant information for you to read.

    I hope this helps to guide you.

    Best wishes,

    Cancer Information Nurse Specialist

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

    Ref: DW/RH