Is it common for a patient's type of multiple myeloma to change -- such as IgG myeloma relapsing as IgA, or vice versa?
If so, how can they determine if it's secondary MGUS or an actual switch in class?
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Change in myeloma type (IgG to IgA, etc)?
Perhaps this will help? I believe it's called banding?
"Different M-Spike After Stem Cell Transplantation Linked To Improved Survival (ASH 2012)," The Myeloma Beacon, Jan 16, 2013.
"Different M-Spike After Stem Cell Transplantation Linked To Improved Survival (ASH 2012)," The Myeloma Beacon, Jan 16, 2013.
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Toni - Name: Toni
- Who do you know with myeloma?: self - MGUS
- When were you/they diagnosed?: April 2014
- Age at diagnosis: 51
Re: Change in myeloma type (IgG to IgA, etc)?
I was diagnosed with IgG multiple myeloma in 2013. I had a bone marrow transplant and have enjoyed a very nice remission ever since.
Over the last three or four months, however, I have noticed a weird trend. Didn't worry me a whole lot given that my numbers at diagnosis included an IgG of considerably over 4000.
What's happening here is that my IgG numbers are beautifully normal – no problems at all. However, my IgA numbers are sneaking up there. Over the last five months, the IgA has increased steadily, and my last test had the IgA at 505, and the IgM at around 35. My oncologist started making concerned noises.
He said that he'd like to just keep me on the Revlimid maintenance dose of 10 mg for 21 days with 7 days off; that he doesn't want to start frantically changing medications at this point, but wants to wait until my numbers get a whole lot worse. He doesn't want to do a bone marrow biopsy or anything yet, which doesn't hurt my feelings any, but the thing is, I didn't bring any of this up. He did.
He also asked me if I was fooling around and not taking my medication. That was insulting, and an entirely different topic.
Oooookay ...
Here are my questions:
1. How common is it for multiple myeloma to switch up this way, i.e., go from IgG to IgA?
2. I wasn't a bit worried until he told me not to worry. Should I be worried?
Over the last three or four months, however, I have noticed a weird trend. Didn't worry me a whole lot given that my numbers at diagnosis included an IgG of considerably over 4000.
What's happening here is that my IgG numbers are beautifully normal – no problems at all. However, my IgA numbers are sneaking up there. Over the last five months, the IgA has increased steadily, and my last test had the IgA at 505, and the IgM at around 35. My oncologist started making concerned noises.
He said that he'd like to just keep me on the Revlimid maintenance dose of 10 mg for 21 days with 7 days off; that he doesn't want to start frantically changing medications at this point, but wants to wait until my numbers get a whole lot worse. He doesn't want to do a bone marrow biopsy or anything yet, which doesn't hurt my feelings any, but the thing is, I didn't bring any of this up. He did.
He also asked me if I was fooling around and not taking my medication. That was insulting, and an entirely different topic.
Oooookay ...
Here are my questions:
1. How common is it for multiple myeloma to switch up this way, i.e., go from IgG to IgA?
2. I wasn't a bit worried until he told me not to worry. Should I be worried?
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dianaiad - Who do you know with myeloma?: Me
- When were you/they diagnosed?: Officially...March 2013
- Age at diagnosis: 63
Re: Change in myeloma type (IgG to IgA, etc)?
This post will give you a rough idea regarding how often one might see an isotype switch (IS) or oligoclonal banding (OB) post-treatment. I'm still a bit unclear about how one actually distinguishes between an IS and OB.
https://myelomabeacon.org/forum/relapse-t8196.html#p48517
This is another good article on the subject:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462372/
https://myelomabeacon.org/forum/relapse-t8196.html#p48517
This is another good article on the subject:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462372/
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Change in myeloma type (IgG to IgA, etc)?
Hi Dianaiad,
Something similar has happened to me. Diagnosed with lambda free light chain multiple myeloma, had a stem cell transplant June 2016, achieved minimal residual disease negative / stringent complete response. Was told I had relapsed in November 2016 due to an M-spike of 0.63. An immunofixation electrophoresis (IFE) on November 30 stated IgG lambda. 10 days later I had bloods done again and this time IFE stated IgG 2 bands, IgA and IgM all of 0.2 value.
Now I asked the consultant if this could be oligoclonal banding rather than relapse and he said not because I already have a history of myeloma! Am having a repeat bone marrow next week.
Regards
Something similar has happened to me. Diagnosed with lambda free light chain multiple myeloma, had a stem cell transplant June 2016, achieved minimal residual disease negative / stringent complete response. Was told I had relapsed in November 2016 due to an M-spike of 0.63. An immunofixation electrophoresis (IFE) on November 30 stated IgG lambda. 10 days later I had bloods done again and this time IFE stated IgG 2 bands, IgA and IgM all of 0.2 value.
Now I asked the consultant if this could be oligoclonal banding rather than relapse and he said not because I already have a history of myeloma! Am having a repeat bone marrow next week.
Regards
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SusanTR1964 - Name: Susan
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 8th February 2016
- Age at diagnosis: 51
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