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75 days post SCBMT results

by ninja performance on Mon Dec 03, 2012 4:33 pm

75 days post SCBMT tests are now all in. SPEP was completely negative, 0 Mspike only 90 IGA (I am IGA). Bone Marrow showed no increase in plasma cells.

But the IFE, immunofixation, test finally came back which tests on a microscopic level for smaller evidence than will show up on an SPEP. And it was positive for the original protein.

Can those proteins showing up on the IFE still be old from pre transplant? or are they new post transplant?

-Chris

ninja performance
Name: Chris Hill
Who do you know with myeloma?: Self
When were you/they diagnosed?: 08/04/2011
Age at diagnosis: 43

Re: 75 days post SCBMT results

by suzierose on Mon Dec 03, 2012 4:50 pm

Hi Ninja!!

Glad to hear you are doing well!

As you note the IFE is far more sensitive than the SPEP...here is some info on levels of sensitivity.

Look at page 16 of slides they show:

Response Criteria: Tumor gene copy number

Diagnosis: 25,000 - 500,000
PR: 5,000 – 100,000
VGPR: 1,500 – 20,000
Immunofixation-negative CR: 1,000 – 10,000
Immunophenotypic CR*: 10 – 100
Molecular CR^: 5 – 20

*Paiva et al Blood 2009;114;4369-72;
^Ladetto et al. J Clin Oncol 2010;28:2077-84
http://myeloma.org/pdfs/Best-of-ASH-2011_01-25-12.pdf

Additionally, IG proteins have a longer half-life and will show up on IFE when the FLC assay looks good, because the free light chains have a shorter half-life and do not show up on FLC assay while the IFE will show protein.

Hope this helps.

wishing you continued good response and speedy recovery!

suzierose
Name: suzierose
When were you/they diagnosed?: 2 sept 2011

Re: 75 days post SCBMT results

by ninja performance on Mon Dec 03, 2012 5:37 pm

Thanks for the reply. With my Mspike at 0 so soon after SCT and IGA in line I was hoping for a negative IFE. So it kinda worries me.

I am not on any maintenance chemo because of the AMils Clinical trial I did along with my SCT.

-Chris

ninja performance
Name: Chris Hill
Who do you know with myeloma?: Self
When were you/they diagnosed?: 08/04/2011
Age at diagnosis: 43

Re: 75 days post SCBMT results

by Dr. Adam Cohen on Tue Dec 04, 2012 11:58 pm

Chris,
The response to SCT sometimes continues to evolve and improve over 6 or even 9 months after the transplant. Plus the IFE results can sometimes fluctuate based on the interpretation of the technician reading the assay, especially with very low level M-proteins. So I wouldn't worry too much about a single positive test on day 75. It sounds like you've had a great response to treatment. Best of luck!

Dr. Adam Cohen
Name: Adam D. Cohen, M.D.
Beacon Medical Advisor


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