I am 14 months post SCT. My M-spike dropped to 0.20 g/dL and has been stable there. About 6 months ago, I developed a faint second M-spike. But now M-spike B is bigger than the original M-spike. When is "faint" no longer faint?
I've read that having several small M-spikes after transplants was actually a positive thing --something to do with an active immune system. But how high does this other M-spike get before it become a concern? It is at 0.30 g/dL now and its trajectory is up.
Thanks, Stann
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Re: 2 M-spikes - polyclonal gammopathy
Hello Stann,
There is a limit to the detection ability of the technology (electrophoresis) used to measure M-spikes. When the level is very low, it is often reported as "trace" only. A significant level would be when the electophoresis results have risen to 0.5 g/dL. By strict International Myeloma Working Group (IMWG) standards, an M-spike at diagnosis is "measurable" at 1 g/dL. Generally, though, treatment is not recommended when all the patient has is a measurable SPEP value.
Progressive disease is defined by the IMWG as a serum M-component increasing by greater than or equal to 0.5 g/dL from the lowest level achieved. However, (this is redundant) even if your level climbs to 0.5 or higher, you do not necessarily need to restart treatment. These are just numbers and do not tell us how your body is doing. So most myeloma doctors would watch you more closely if the number is climbing but hold treatment until you developed some aspect of the "CRAB" criteria again.
The finding of multiple new small bands in the SPEP after a transplant is called "oligoclonal banding" and seems to predict a better response.
Thank you for asking this excellent question.
There is a limit to the detection ability of the technology (electrophoresis) used to measure M-spikes. When the level is very low, it is often reported as "trace" only. A significant level would be when the electophoresis results have risen to 0.5 g/dL. By strict International Myeloma Working Group (IMWG) standards, an M-spike at diagnosis is "measurable" at 1 g/dL. Generally, though, treatment is not recommended when all the patient has is a measurable SPEP value.
Progressive disease is defined by the IMWG as a serum M-component increasing by greater than or equal to 0.5 g/dL from the lowest level achieved. However, (this is redundant) even if your level climbs to 0.5 or higher, you do not necessarily need to restart treatment. These are just numbers and do not tell us how your body is doing. So most myeloma doctors would watch you more closely if the number is climbing but hold treatment until you developed some aspect of the "CRAB" criteria again.
The finding of multiple new small bands in the SPEP after a transplant is called "oligoclonal banding" and seems to predict a better response.
Thank you for asking this excellent question.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
3 posts
• Page 1 of 1