Sunday, November 25, 2012

Blood Tests: Too Many Acronyms

This is the first in a series of riveting blog posts called:

Tests and Procedures I Have Had Since Diagnosis!
Ooohh....ahhh....I know, you can barely contain your excitement.
First post: the blood test.

Every time I have an appointment with my hem/onc I have to go one hour before for blood work. Blood tests are mostly painless except for the initial poke (or in my case several pokes - crappy veins) of the needle. Many of the results are ready an hour later at my appointment which is convenient. However, the really important tests like the SPEP & IEP  (serum protein electrophoresis and immunoelectrophoresis...see, here we go with the acronyms) are not ready for about a week. To be honest, only recently have I really started to understand what all these tests are and what they indicate.

I gathered information from the Multiple Myeloma Research Foundation. This is a short version description of the blood tests:

  • Complete Blood Count (CBC) - tells the number of red blood cells, white blood cells, and platelets; and relative proportion of white blood cells. This test helps determine the degree to which myeloma is interfering with the normal production of blood cells. Low levels may signal anemia, increased risk of infection, and poor clotting.
  • Chemestry Profile - albumin, calcium, lactate dehydrogenase, blood urea nitrogen (BUN) and creatinine. This test is used to determine general health and check liver and kidney function.
  • Beta 2 -microglobulin - Determine the level of a serum protein that reflects both disease activity and renal function. High levels indicate more extensive disease.
  • C-Reactive Protein - Indirect measure of cancer cells. High levels indicate more extensive disease.
  • Immunoglobulin Levels - Define the levels of antibodies that are overproduced by myeloma cells. Higher levels indicate more extensive disease.
  • Serum Protein Electrophoresis - indicate the level or presense of proteins, including m-protein
  • Immunofixation Electrophoresis - identify the type of abdormal antibody protein in the blood
  • Freelite serum free light chain assay - measure immunoglobulin light chains. Abnormal levels and/or ratio suggest the presence of myeloma or a related disease.
When I log onto my patient portal online I can see most of the test results (except pathology - SPEP, IEP, and biopsies). If you click on a particular test it will show all the results of that particular test from previous dates as well. It's nice to compare to see if the numbers are trending up or down or staying stable.

Here are some of my most recent results. Reference range is to the right. Numbers are flagged as low/high with a (#).

Sodium 141                         135-145    

Potassium 3.8                   3.5-5.0

Chloride 104                      98-108   

Carbon Dioxide 27              23-32  
 ALT (SGPT)  11                      7-52  

 AST (SGOT) 20                   9-30    

LDH 125                              107-231  

 Alk Phos 55                           36-118  

 Bilirubin (Total) 0.4          0.2-1.2   

 Total Protein 7.8               6.0-8.0   

 Albumin 4.9                        3.7-5.4   

 Globulin 2.9                          2.3-4.2   

 BUN 6(#)                                 9-25   

Calcium 9.7                       8.8-10.5    

Creatinine 0.60(#)               0.7-1.3

 Glucose 76                       65-105  

 WBC 5.9                        3.8-9.2   

 HCT 34.4(#)                         34.8-43.6  

 Hgb 12.0                      11.9-15.0   

 RBC 4.34                       3.8-5.0   

 PLT 180                          155-410   

 MCV 82.6                            81-97   

 MCH 28.8                                  27.6-33.9   

 MCHC 34.8                           33.3-35.4   

 RDW 13.2                            11.5-14.8   

 Neutrophils (auto) 59       49-79   

 Blasts 0 %   

 Neutrophil # (auto) 3.48        2.0-6.4   

 RBC Morph (manual) NORM     

 PLT Comments/Morphology WITHIN NORMAL LIMITS     

 IgG 1200       700-1600  

 IgA 163          70-400  

 IgM 127         40-230   

 Kappa/Lambda Ratio    0.718        0.26-1.65  

 Eos 2 %        0-6  

 Basos 1 %       0-1  

 Lymphs 32 %      11-38   

 Monos 4 (#)              5-12   

 Eos# 0.12              0.0-0.4   

 Baso# 0.06           0.0-0.1   

 Lymph# 1.89             0.5-2.6   

 Mono# 0.35            0.2-0.9   

 Blast # (manual)        0.00 K/UL   

 B2 microglobulin 1.5          0-2.7 


Lambda Free Light Chains  4.33 (#)       5.7-26.3  

Kappa Free Light Chains     3.11 (#)       3.3-19.4

 CRP    10.8 (#)

 ESR 36 (#)   0-18

Gamma M Spike 1: .39


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