[La Reina]

IgA immunoglobulin vs. M-spike

by La Reina on Tue Jan 25, 2011 5:21 pm

My blood work indicates an IgA of 3580 and an M-spike of 1.94. Would someone please tell me what the difference and significance of these are? Thanks.

[Dr. Craig Hofmeister]

Re: IgA immunoglobulin vs. M-spike

by Dr. Craig Hofmeister on Sat Jan 29, 2011 6:52 pm

In general, you make a certain amount of immunoglobulins (IgA, igG, IgM, IgD, igE) and, in a myeloma patient, the immunoglobulin type that is "involved" (for you it's IgA) can be divided into IgA that is produced by your normal plasma cells and IgA that is produced by your myeloma cells.

With you as an example, your total IgA is 3580 mg/dL and the proportion of your IgA that is secreted by your myeloma cells is 1940 mg/dL.

But, be careful, for patients with IgA myeloma, it is especially hard to accurately define the "M-spike", i.e. the portion of IgA produced by your myeloma cells, primarily because the IgA immunoglobulin is about the same "size" as other normal proteins in your blood. There are even somewhat ridiculous times when a lab comes back with an IgA of 3000 mg/dL and an "M-spike" of 3100 mg/dL of IgA lambda, or some such thing. This is obviously a limit of the current technology.

[La Reina]

Re: IgA immunoglobulin vs. M-spike

by La Reina on Fri Feb 11, 2011 4:50 pm

So if IgA M-spike is so difficult to determine, what would be a more accurate determinant of disease state?

Thanks for answering,

[desertrodent]

Re: IgA immunoglobulin vs. M-spike

by desertrodent on Tue Feb 22, 2011 5:42 am

From Dr. Hofmeister's explanation, if a patient has a total IgG of 1680 and an M-Spike of 1.3, is that a worse ratio than the above example that he mentioned, as far as myeloma goes?

[LMOSS]

Re: IgA immunoglobulin vs. M-spike

by LMOSS on Tue Sep 20, 2011 7:51 am

My test results show an IgA level of 1640 and I was told I have no M-Spike. What does that mean? Thanks.

[Dr. Peter Voorhees]

Re: IgA immunoglobulin vs. M-spike

by Dr. Peter Voorhees on Mon Sep 26, 2011 6:07 am

Dear LMOSS,

If your myeloma was making a monoclonal IgA antibody at initial diagnosis, I would be surprised if you did not have an M spike with an IgA level of 1640 mg/dL. The upper limits of normal for serum IgA is typically in the 400 range.

I would clarify this with your doctor and, if necessary, repeat the testing. Good luck to you!

Pete V.

[ghallow]

Re: IgA immunoglobulin vs. M-spike

by ghallow on Tue Feb 21, 2012 11:29 pm

So, I have been managing my fathers care and he was diagnosed with Stage IIA multiple myeloma in December. We started treatment one month ago of Revlimid, Velcade, Zometa and dex. His IgA was 940 mg and M-Spike was 1.5. After 30 days, his IgA is 410 mg and M-Spike is 1.3. The doctor was very pleased and even told me today he thinks my father will achieve remission.

My question is: After reading the thread, am I to believe that his M-spike is 1300 mg? Is that possible?

Thanks!
Greg