Can someone help me read my husbands lab report, particularly the Immunofix. Serum and Serum immunoglobulins. He has IgG lamba multipe myeloma.
Immunofix Serum says "Specific M-protein cannot be identified"
Quantitative Serum Immunoglobulins
IgG IFCC 424
IgA IFCC <30
IgM, IFCC <26
Kappa Free LTCHN <0.04
Lambda Free LT CH <0.05
I don't know what to keep an eye on. He just finished 2 stem cell transplants and consolidation treatment. I just want to know what to watch for. What's most important and what direction or level should it be?
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Re: Help understand husband's Serum Immunoglobulins results
His normal plasma cells make a number of types of antibodies (IgG, IgA, IgM, etc.) of all different shapes and sizes. Because there is no group of antibodies of all the same size and shape, nothing is monoclonal. When there is a group of antibodies that are monoclonal, they come from a group of plasma cells (or potentially other lymphocytes) that are all the same and make exactly the same antibody. A serum protein electrophoresis (SPEP) sorts all the antibodies in the blood or urine by size & shape, and looks for a group that's all exactly the same size and shape. Immunofixation looks to identify the monoclonal antibody, to really name whether it's IgG-lambda or IgG-kapp for instance.
Here's the thing - the amount of IgG-Lambda in his blood is a reflection of how many myeloma cells are in his body. If his blood shows normal amounts of IgG, but no evidence of myeloma produced IgG-L, then that is, simply put, a remission. If it shows very little normal IgG, and no evidence of IgG-L, then that means he's in remission but he's been through a lot of chemotherapy.
In addition the lab report looks at the circulating kappa and lambda light chains and they were all undetectable. Again signifying that he's been through a lot of chemotherapy.
Here's the thing - the amount of IgG-Lambda in his blood is a reflection of how many myeloma cells are in his body. If his blood shows normal amounts of IgG, but no evidence of myeloma produced IgG-L, then that is, simply put, a remission. If it shows very little normal IgG, and no evidence of IgG-L, then that means he's in remission but he's been through a lot of chemotherapy.
In addition the lab report looks at the circulating kappa and lambda light chains and they were all undetectable. Again signifying that he's been through a lot of chemotherapy.
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Dr. Craig Hofmeister - Name: Craig C. Hofmeister, M.D.
Re: Help understand husband's Serum Immunoglobulins results
Good information. Could you tell me what this all actually means?
FREE KAPPA/LAMBDA RATIO 11.60
FREE LAMBDA LIGHT CHAIN 2.38 L MG/L
FREE KAPPA LIGHT CHAIN 27.60 H MG/L
IMMUNOGLOBULIN IgG 641 L MG/DL
IMMUNOGLOBULIN IgA 1650 H MG/DL
IMMUNOGLOBULIN IgM 12 L MG/DL
FREE KAPPA/LAMBDA RATIO 11.60
FREE LAMBDA LIGHT CHAIN 2.38 L MG/L
FREE KAPPA LIGHT CHAIN 27.60 H MG/L
IMMUNOGLOBULIN IgG 641 L MG/DL
IMMUNOGLOBULIN IgA 1650 H MG/DL
IMMUNOGLOBULIN IgM 12 L MG/DL
Re: Help understand husband's Serum Immunoglobulins results
Hi,
It is important to know the normal ranges for me to comment specifically. The serum free light chains tell you if there is excess of either kappa or lambda light chains which are made by the plasma cells. An excess of one or the other is often seen in myeloma or in monoclonal gammopathy of uncertain significance (MGUS). It appears there is an excess of kappa light chains and an elevated kappa/lambda ratio but again, would need to know the normal ranges to be absolutely sure. The immunoglobulin levels need to be checked against the normal ranges. These do not appear out of the range of normal. We normally look for the amount of monoclonal protein or the M-spike which is part of the serum protein electrophoresis. This is one way to measure the myeloma tumor burden along with other blood tests, bone marrow tests, urine testing and radiology tests.
It is important to know the normal ranges for me to comment specifically. The serum free light chains tell you if there is excess of either kappa or lambda light chains which are made by the plasma cells. An excess of one or the other is often seen in myeloma or in monoclonal gammopathy of uncertain significance (MGUS). It appears there is an excess of kappa light chains and an elevated kappa/lambda ratio but again, would need to know the normal ranges to be absolutely sure. The immunoglobulin levels need to be checked against the normal ranges. These do not appear out of the range of normal. We normally look for the amount of monoclonal protein or the M-spike which is part of the serum protein electrophoresis. This is one way to measure the myeloma tumor burden along with other blood tests, bone marrow tests, urine testing and radiology tests.
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Dr. Philip McCarthy - Name: Philip McCarthy Jr., M.D.
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