Paraprotein 5 gl is it MGUS?

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Hi I had paraproteins detected at a routine blood test during a nasty chest infection last year. Had another infection ( I have bronchoectasis, so these are not unusual for me) a month ago and a similar low level, the respiratory consultant said these are just above UNL and has referred me to a haematology department. I have a haematology appointment on 2 August and am extremely worried about it. I have a few questions and it would be great if you could reply within a couple of days. Why I wasn't given an appointment for the first time the paraprotein was detected? Was it because they thought it was low and just a transient symptom of infection? As it is the second time it is detected the respiratory consultant said it is just above upper normal limit. But there is no normal limit for paraprotein, so I am slightly confused. They mentioned that paraprotein is persistent, but I cannot see the current level at the patient page, I assume it is the same level of 5 gl. Could it be a sign of lengthy infection or is it definitely MGUS symptom? This is IGG paraprotein, so I understand that risk is low. Please could you clarify the risk factor for progression to myeloma? On some websites 1 percent risk level is mentioned, while on others it says that the risk increases by 1 per cent each year, so in 10 years it will be a 10 % chance of getting myeloma or lymphoma? Would be grateful if you could clarify something for me while waiting for the appointment. 

kind regards

Miranda

  • Hi Miranda123,

     

    Thank you for getting in touch and welcome to the online community.  My name is Adrienne and I’m one of the Cancer Information Nurse Specialists.

    It’s completely understandable that you would be worried and have a lot of questions around the detection of paraproteins in your blood.  On the support line, we do not have access to your NHS medical records so we can’t say exactly why your respiratory consultant did not refer you when they were first detected.  That being said, there are guidelines that doctors follow to assess when referral should be done to haematology and whether it should be done as a matter of urgency. 

    The guidelines state that if a paraprotein IgG level of less that 15g/L is found, blood and urine should be rechecked to confirm a pattern and check for any changes/progression.  Therefore does not require immediate referral to haematology.   As you mentioned that your initial level was 5g/L, this may be why your respiratory consultant decided to wait and recheck your levels before making the referral.  You can read more about the management of patients with paraproteins here.  Myeloma UK also have a guide for GP’s on when to refer to haematology and you can see more information on page 15 of the online booklet here

    It is rare for paraproteins to be transient and associated with infections although small levels can be associated with some skin diseases, connective tissue disorders and hepatitis C.

    It’s important to know that although monoclonal gammopathy of unknown significance (MGUS) does mean there is a slightly higher risk of developing myeloma, most people who have it never develop a related cancer and do not need treatment.  Approximately 65% of patients presenting with excessive amounts of paraproteins (paraproteinaemia) do not have a demonstrable cancer and are described as having MGUS.  Of that 65%, only 1% of them will go on to develop a myeloma or low-grade lymphoma.  This statistic is very generalised and it’s a combination of test results that will identify your particular risk.  There is a calculator that you can use to determine your particular risk once you have seen your consultant haematologist. We would advise you to speak to your consultant to see if this tool would be appropriate for your situation.  They can offer some support and guidance around the use of this tool and help interpret the data to help avoid any confusion.  You can access this calculator by clicking here

    It might be helpful to write down some questions before your appointment in August, just so you are prepared and don’t forget anything you may want to ask on the day.

    I really do hope this information was helpful but please know that you can get back in touch with us at any time.

    I wish you all the best with your upcoming appointment.

     

    Take care and best wishes,

     

    Adrienne

     

    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:  AMc/KM