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Was diagnosed with Smoldering Multiple Myeloma. Lab test showed high IMM level. Should I consult oncologist?

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General & Family Physician
Practicing since : 2009
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I was diagnosed with Smoldering Multiple Myeloma almost 2 years ago ( I am not currently be treated), yesterday I got my pre employment Lab results back and my IMM GRAN # is high, double the high cut off for the lab, should I be concerned or take these results to my Hematologist/Oncologist? I do not currently have any symptoms of an infection. I will be starting employment at my local hospital at the end of the week as a newly licensed Practical Nurse, do I need to be concerned about exposing myself to illness, does this result mean that my Myeloma may be progressing?
Posted Tue, 3 Dec 2013 in Blood Disorders
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: Oncologist; yes, low immunity; cannot say Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. As for the high immature granulocytes that were detected, this indicates a bone marrow abnormality and yes, possibly that your multiple myeloma (MM) could be progressing, but this cannot be confirmed with this superficial investigation. In my opinion, most MM cases require a team of doctors which include an oncologist, a hematologist and a general physician. So, as of now it would be best to visit an oncologist first, who would surely then rope in the other experts. I should also add that, the conducted tests might not be sufficient. Your doctor, will also conduct other investigations which will help in staging the myeloma, based on which treatment will be directed. I can understand how you might be worried about the same ma'am, but it is best not to ignore this. With medical management, I am sure you will be able to lead the normal life that you are hoping for. Please do schedule an appointment with an oncologist at your earliest convenience. Yes ma'am, MM results in an impaired immunity which can make you more susceptible to infections, even more as you will be working at a hospital. Please first consult your oncologist and then start work, as I feel this would be best for you. As for progression, I cannot really say whether or not your MM has progressed, as this investigation only helps in detecting the bone marrow abnormality, but not the stage it is in. Only other tests like x-rays, CT scans, PET scan, bone marrow examination, etc; can help in staging and proving or ruling out progression. I hope I have succeeded in providing the information you needed ma'm. Please forgive me if I have not explained any particular point to your best understanding. Please feel free to write back to me for any further clarifications or information, I would be more than happy to help. Best wishes.
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Follow-up: Was diagnosed with Smoldering Multiple Myeloma. Lab test showed high IMM level. Should I consult oncologist? 49 minutes later
Tank you for getting back to me so quickly. I just did not want to call my Oncologist if there was more than likely no real concern, as I worry about disease progression a lot and try not to over react about every little "off" lab result that I get. I am not scheduled to see him until April, so I didn't want to wait that long if this could be something of concern, as well. The rest of my results are WNL, some are on the high end of "normal", but still normal. The reference range for this particular lab for IMM GRAN # is 0.0052-0.0224, My result is flagged high, it is 0.0400. The IMM GRAN % is WNL at 0.4, with the labs high reference being 0.5. My WBC is 10.6 K/mm3 with the labs reference high being 10.8 K/mm3 and my platelets are 390 K/mm3 with the labs reference high being 400 K/mm3...Would you recommend calling my PCP with these results first or just going ahead and calling my Oncologist/Hematologist? Again thank you so much for your time, it is greatly appreciated.
Answered by Dr. Shoaib Khan 32 minutes later
Brief Answer: As of now consult PCP; worried about stage only Detailed Answer: Hello once again ma'am. It is my pleasure to be of assistance. I am happy to know that all the other results are normal, as this shows that your condition is still not in the later stages, and with such reports you may visit your PCP, and it might not be necessary to visit your oncologist now. But, the real thing I am worried about here is the stage of your MM, which only your oncologist can assess. This is something we need to know and keep track of. As of now, you can visit your PCP ma'am, but try to meet your oncologist a little earlier, if that is not possible, do not worry, meet him/her whenever possible, and get an elaborate evaluation done. For now, take care of yourself and try to stay as protected from infectious patients as possible. Wishing and hoping this is only in its early stages and nothing serious. Please feel free to keep in touch with me for any further clarifications, I would be more than happy to help. Take care ma'am.
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Follow-up: Was diagnosed with Smoldering Multiple Myeloma. Lab test showed high IMM level. Should I consult oncologist? 21 hours later
Thanks again, I was unsure if this result might have anything to do with progression or development of another "related" cancer, as that is a concern for MM patients. I am having the test repeated in a week or so, hopefully the results are WNL then and it was just some sort of asymptomatic infection going on...if not I will see my Oncologist. Do you see these results backing down to normal in many patients? Thanks again for your time and professional opinion, it has been much appreciated. Bless you.
Answered by Dr. Shoaib Khan 19 minutes later
Brief Answer: Yes they do get back to normal quite often Detailed Answer: Hello once again ma'am. Thank you for your blessings, it is all I seek. Yes of course I do ma'am. Patients with MM have all sorts of fluctuations, sometimes within a few days levels drop to WNL and sometimes just the opposite. Which is why I expressed concern to learn about your stage. Other than that, I only hope and pray that your MM is always under control and never causes any harm or concern to you. My best wishes and prayers shall be with you, May god bless you with his abundance.
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