Monday, August 20, 2007

I am a 38-year-old female with chronic joint pain, left rib pain and fatigue. My doctor ran a serum protein test, and I have had a steady M-spike of .30 for about a year and a half. My bone marrow biopsy was negative for myeloma. Can an M-spike mean absolutely nothing? Or does it mean that at some point I may have to deal with myeloma? Do healthy people have M-spikes?

It sounds as though you have a monoclonal gammopathy of undetermined significance (MGUS).  MGUS is characterized by an M protein less than 3 g/dL, less than 10 percent plasma cells in the bone marrow, little or no Bence-Jones protein in the urine, no lytic lesions on bone survey and no evidence of kidney damage. Approximately 1 percent of patients per year with MGUS develop a blood cell cancer (for example, multiple myeloma, lymphoma or chronic lymphocytic leukemia).  However, the remainder will likely have a life expectancy unaffected by their MGUS.

Though the chance of developing a blood cell cancer is relatively small, you should have follow-up visits with a hematologist or oncologist every six months for the first two years, and annually thereafter, to keep an eye on this.