The Myeloma Beacon

Independent, up-to-date news and information for the multiple myeloma community.
Home page Deutsche Artikel Artículos Españoles

Forums

General questions and discussion about multiple myeloma (i.e., symptoms, lab results, news, etc.) If unsure where to post, use this discussion area.

Now have two m-spikes - IgA kappa & IgG kappa

by WeatherNurse13 on Thu Jul 24, 2014 7:19 pm

My recent immunofixation results showed large IgA kappa monoclones and small IgG kappa monoclones. Does this have any special meaning? Can you have two types of multiple myeloma, IgA and IgG?

I am being restaged after a 18 month remission and have experienced more back pain, fatigue, headaches and profuse sweating.

My awesome oncologist has ordered all the blood and urine tests and will do a bone marrow biopsy next week. SPEP results are 4.4 in gamma. Total proteins 9.7.

I am expecting that this means I have relapsed, just haven't heard of having two types of monoclones.

WeatherNurse13
Name: Gracie
Who do you know with myeloma?: Self
When were you/they diagnosed?: 10/2012
Age at diagnosis: 49

Re: Now have two m-spikes - IgA kappa & IgG kappa

by blair77 on Thu Jul 24, 2014 7:56 pm

Which immunoglobulin was the original protein?

blair77
Who do you know with myeloma?: My husband
When were you/they diagnosed?: April 2013
Age at diagnosis: 43

Re: Now have two m-spikes - IgA kappa & IgG kappa

by WeatherNurse13 on Thu Jul 24, 2014 8:01 pm

IgA kappa.

WeatherNurse13
Name: Gracie
Who do you know with myeloma?: Self
When were you/they diagnosed?: 10/2012
Age at diagnosis: 49

Re: Now have two m-spikes - IgA kappa & IgG kappa

by blair77 on Thu Jul 24, 2014 8:11 pm

There is such a thing as biclonal gammopathy. However, I'm not sure it has any significance. I'm so sorry to hear of your possible relapse.

blair77
Who do you know with myeloma?: My husband
When were you/they diagnosed?: April 2013
Age at diagnosis: 43

Re: Now have two m-spikes - IgA kappa & IgG kappa

by Multibilly on Fri Jul 25, 2014 8:02 am

Gracie: I'm not clear if the following pertains to your situation or not:

"Different M-Spike After Stem Cell Transplantation Linked To Improved Survival (ASH 2012)", The Myeloma Beacon, January 16, 2013.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: Now have two m-spikes - IgA kappa & IgG kappa

by kjpoppit on Fri Jul 25, 2014 2:32 pm

I had both IgA and IgG when I was diagnosed. I recently finished an auto transplant and both are gone and I have no detectable M spike at this time. Yet, weird thing is my tests said I had an IgM monoclonal band now but no M-spike. This seems weird to me and my doctor is having the results rechecked.

Anyhow, it is possible to have more than one type at the same time.

Best of luck to you.

Kim

kjpoppit
Name: Kim Nelson
Who do you know with myeloma?: Me
When were you/they diagnosed?: Sept. 19th, 2013
Age at diagnosis: 47

Re: Now have two m-spikes - IgA kappa & IgG kappa

by Multibilly on Fri Jul 25, 2014 3:22 pm

Boy, it sure seems like there are a fair number of folks on the Beacon that have biclonal (I use that term loosely here) gammopathies with different heavy chains, biclonal gammopathies with different free light chains, banding, oligoclonal banding, etc. Some have this situation pre-SCT, post-SCT and even at the MGUS stage. Just based on the number of posts I've come across recently, it strikes me that this is more common than the 1% or so of cases that one sees in the literature.

I'm also frankly confused by the differences in all these variations and whether biclonal gammopathies are the same as the "banding" pheonomena and what the prognostic significance is of each variation.

There are also some great questions that have recently come up regarding how to deal with FLC ratios and values if you have a biclonal gammopathy that involves both kappa and lambda, how to reconcile the supposed goodness of having banding occur post-SCT (esp if one is trying to get to sCR with no M-Spike, etc).

Beacon Staff, perhaps you might be able to help us sort this all out?

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: Now have two m-spikes - IgA kappa & IgG kappa

by Beacon Staff on Fri Jul 25, 2014 3:46 pm

Interesting you should post this, Multibilly, because we just sent out an inquiry earlier this afternoon to clarify something in regard to one of the recent questions on this general topic.

We'll let you know what we hear back and also look into getting feedback on some of the other related questions that have been raised (and which you've mentioned).

Thanks!

Beacon Staff

Re: Now have two m-spikes - IgA kappa & IgG kappa

by blair77 on Fri Jul 25, 2014 4:04 pm

Post transplant my husband had a 0.1 spike of IgM (his original m spike was IgA). Over the last couple months he has had no m spike but banding of IgM, sometimes more then one band. However, his original IgA has never reappeared on any of the tests and some months this new band of IgM is there and sometimes not.

blair77
Who do you know with myeloma?: My husband
When were you/they diagnosed?: April 2013
Age at diagnosis: 43

Re: Now have two m-spikes - IgA kappa & IgG kappa

by WeatherNurse13 on Fri Jul 25, 2014 4:23 pm

Thanks for all of your responses!

My original m-spike was IgA (4.4). So my m-protein didn't change, but a small amount of monoclonal IgG proteins were identified this time. IgA was found to be in large amounts.

My IgA is elevated over 3,000 (469 in May) and my IgG is falling 800 (1319 in May). Both are kappa.

WeatherNurse13
Name: Gracie
Who do you know with myeloma?: Self
When were you/they diagnosed?: 10/2012
Age at diagnosis: 49

Next

Return to Multiple Myeloma