Brief Answer: Considerations. Detailed Answer: Hello and thank you for sharing your laboratory results. As you might already know monoclonal gammopathy of undetermined significance is an entity which we follow relatively conservatively. It does require interval laboratory evaluations every 3-6 months initially. I would be curious to know why you had the iron deficiency. I wonder if this was related to dietary iron deficiency or if you had some type of gastrointestinal bleeding. As long as your blood count has recovered to normal this is not necessarily very worrisome but I was just wondering about what might be causing the iron deficiency. You also might know that bone marrow biopsy is not necessarily indicated at this point. Your doctor would probably consider that if you develop any decreasing your blood counts or if your kidney function changed or if you develop hypercalcemia or bone lesions. The field of multiple myeloma has evolved rapidly over the past 10-15 years. You may never require treatment. However, if you do require treatment we have excellent treatment options which often put the disease into remission for long periods of time. That is a small consolation but still relatively reassuring as modern medicine advances. Thanks again for sharing your healthcare concern. Please let us know if you have any specific concerns that you would like to discuss with us. Sincerely, Dr. Galamaga

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Brief Answer: Followup Detailed Answer: The A/G ratio in your case is not suggestive of leukemia. Globulin level may sometimes be affected by nutrition. The affect is not usually that significant however. Again you most likely have monoclonal gammopathy which can be followed conservatively. No interventions needed to be done and close monitoring is absolutely adequate. Sincerely Dr. Galamaga

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