[lwem]

Re: Can M-spike and free light chain lab results diverge?

by lwem on Sat Mar 10, 2018 2:11 pm

Hi Anna,

I do not believe that the fact that he secretes only whole immunoglobulins has any effect on his prognosis. He does have other features of high risk myeloma, such as tp53 deletion and 1q21 gain.

The free light chain assay only helps when we want to track his healthy and uninvolved immunoglobulins, which are extremely low and so his free light chains are almost undetectable in recent months despite having an M-spike.

Also, more significant than his M-spike are his other blood work numbers, because his M-spike is not that high, so his health and myeloma impact are better monitored through these other numbers such as the CBC and metabolic panel. This is because his bone marrow is so low on reserves that any M-spike seems to have a big impact on his health. He has been transfusion dependent in recent months even though his M-spike is only 0.76 g/dL (7.6 g/l).