Myeloma Protein Levels in the Blood and the Amount of Myeloma in the Body

In this episode, Dr. Brian G.M. Durie discusses how the level of myeloma protein found in the blood corresponds to the amount of myeloma found in the body.

The BOTTOM LINE: 

Discuss your situation with your doctor and establish how best to track your disease.

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Transcript:

This week’s “Ask Dr. Durie” question comes from a patient concerned about how the level of the myeloma protein in the blood correlates with the amount of myeloma in the body. This turns out to be a central question for all myeloma patients. 

Some myeloma cells produce very little protein, whereas other myeloma cells produce a lot of protein. What this means is that if the myeloma is producing a very small amount of protein there could be quite a lot of myeloma in the body, even although the blood myeloma protein level is low.  

The opposite is also true for patients who are, what we call, high producers. They could have a very high level of myeloma protein. However, the amount of myeloma could be a whole lot less.  

What this means is that the tracking of the protein level and the tracking of the myeloma must be done on an individual basis because a low level of protein could be a fantastic response in a patient who had a very high level to start with. Whereas, for a patient with low level protein disease, this could mean that there’s not been much of a response to treatment.

For patients with low level protein production, it can be especially challenging to assess the status of the disease because with very low numbers it can be hard to tell if the level is dropping or if it’s going up slightly.  

In those cases, additional testing may be required to assess the status of the disease. Things like a whole-body PET scan, or MRI, or a follow-up bone marrow test to see what the percentage of the plasma cells in the bone marrow is. 

In this case, the BOTTOM LINE is that this is a very important topic to discuss with your personal doctor so that you both are aware if you’re a low producer or a high producer, and to set up the best ways to track the myeloma in your case. Understand what a low-level means, and what a higher level might mean in your individual case based upon the findings at the start of treatment. It is an important question and something that you should talk over carefully with your doctor.  

Dr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.