I have received a couple of interesting emails lately regarding the connection between MM and autoimmune diseases, including Lyme Disease. One writer, Kate, has IGA Lambda MM with the t(4;14) translocation, as I have. While she says she does not have Lyme, she suffers from a variety of symptoms that her doctors say are autoimmune related. (I wonder if she might actually have a case of undiagnosed Lyme. Since the tests are so unreliable, there may be no way to know for sure.) Her oncologist acknowledges an association between autoimmune disorders and MM, but the MM experts don't know what the relationship is yet. She has also read that IGA MM patients have higher rates of both autoimmune diseases and t(4;14) translocations than other types. Interesting. This just adds more fuel to the fire about this type of connection, as far as I'm concerned.
Today I received a fascinating comment on one of my earlier posts about Lyme Disease. Dee has been treated for Lyme Disease several times, but she feels she had undiagnosed Lyme before that. She continues to have the usual range of symptoms indicating chronic Lyme. Fortunately, she is seeing a Lyme-literate doctor.
This year, she was diagnosed with an extremely rare disease: necrobiotic xanthogranuloma (NXG). Only about 125 cases a year are reported for this disease, and most of the literature is from Europe, primarily by those in the Lyme Disease community. However, NXG has been found to have a very high correlation with MM. She went to an oncologist and found she had elevated monoclonal protein. After a bone marrow biopsy (BMB), she was found to have Smoldering Myeloma (SM), and they also found Lyme bacteria Borrelia burgdorferi (Bb) spirochetes in her bone marrow! Wow!
This seems to establish a potential triad between Lyme Disease, NXG, and Multiple Myeloma. In fact, I found a paper establishing this 3-way link: http://www.medscape.com/viewarticle/721924_5. In a retrospective study, 80% of NXG patients showed monoclonal gammopathies. Furthermore, the paper states, "NXG biopsies suggested the presence of Borrelia spirochetes in six of seven samples, implicating spirochetes as a potential trigger for NXG".
Right now, my head hurts trying to assimilate all this information. While NXG is very rare, this reveals one probable pathway between Lyme Disease and myeloma, showing that the Lyme Bb instigates the NXG, which in turn instigates the monoclonal gammopathy. This implies cause and effect, not merely correlation. Bb is an extremely complicated and resourceful bacterium. It has many deleterious effects on the human body (as I myself have discovered), but I remain convinced that one of the more pernicious effects is that Lyme Disease is a potential trigger for monoclonal gammopathies, including MGUS, SM, and MM. I'm sure I will be blogging about this more as I gather more information on this topic.
Tomorrow I am headed up to the family farm in Champlain, NY for a relaxing weekend with my son, Jeff, and good friend, Bobby. Since we don't have good wireless connections there, I may miss a good blog talk radio show tomorrow night at 6:00 featuring Dr. Paul Richardson. Here is the link: http://www.blogtalkradio.com/dr-paul-richardson-discusses-myeloma. The topic is To Transplant or Not To Transplant: Thats the Question. Fellow blogger Pat Killingsworth is one of the panelists. I already know Paul's view on this, as we have discussed it at length. However, it is a hot topic of conversation these days in the MM community. Several clinical trials are underway to help answer this question (including the one I am on), so it will be interesting to see if there are any new developments on this topic. If I miss it, I hope someone will fill me in on it, or I can view it later.