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History of TTP. Serum light chain test normal. B2 microglobulin normal. Likelihood of turning into MM?

Hi and thank you. I m a 44 year old man who had TTP in May of 2007. I recovered from this (thanks G-d) after many, many months of plasmapherisis, rituximab and predinsone. I ve not had a relapse. In October of 2012, my SPEP showed a very, very faint monoclonal protein which is MGUS. We repeated the SPEP on March 1st and it was still labled very, very faint monoclonal protein . We did a free serum light chain test that showed my kappa and Lambda in normal range as well as the kappa/lambda ratio . My B2-Microglobulin was also normal 1,949 . My calcium is normal 9.7, CBC, liver and kidney functions are all perfectly settled in the normal ranges. What s the likelihood in your opinion of this turning into MM or someother type of plasma cell dyscricia? Thanks so much.
Asked On : Sun, 17 Mar 2013
Answers:  2 Views:  66
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Internal Medicine Specialist 's  Response
Thanks for query
Yes we can predict your 10 year risk of MM with reasonable certainty. Of the tests you got done only free serum light chain test will be of some value in prediction.Depending on your country of residence and availability of tests and your own insurance/ financial status we can devise some tests. I would personally recommend flow cytometry for activated plasma cells (aPL) but it is available in tertiary institutes only.
You can contact me for detailed discussion
Hope you find it helpful
Answered: Sat, 6 Apr 2013
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Hematologist Dr. Ankita's  Response
It is also necessary to rule out other conditions like lymphoma by imaging studies like CT scan that could explain the M band. Do let me know if this has been looked into.Take care
Answered: Sat, 6 Apr 2013
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