Greetings,
My father was diagnosed with multiple myeloma in July 2012. He has taken different types of treatment since then. However, the situation didn't seem to get controlled. He is trying Pomalyst (pomalidomide, Imnovid) ＋dexamethasone lately.
The first month's report looks confusing to me. What does that mean? Why is IgA and lambda extremely high? Does that mean very bad?
IgG 282
IgA 1740
IgM 11
Free kappa 2.01
Free Lambda 176
K/L ratio 0.01
Total protein 67
There is also something like Paraprotein1 to 4 in the report . What does that mean?
Besides, is anyone taken pomalidomide? I saw my father suffered a lot by taking this medicine.
Thank you very much for your time.
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Re: High IgA and high lambda free light chain
Hi Charlene,
Welcome to the forum.
Are you based in the UK or elsewhere in Europe?
The key thing to look at with multiple myeloma are the trends and not so much just one snapshot in time. So, you would want to see what these numbers have done over time and with different treatments.
While the IgA number looks large, it isn't extremely high (assuming a normal range of 91-414 mg/dL) by multiple myeloma standards. The paraprotein reading is what is commonly referred to as the "M-spike", which in this case measures the amount of monoclonal IgA in your dad's blood. Given he has an IgA level of 1741 mg/dL, I'm guessing that the paraprotein level (M-spike) actually read out as 1.4 g/dL (1400 mg/dL or 14 g/L)
It also looks like his IgG and IgM levels are suppressed, which is a condition known as immunoparesis and signals that his disease isn't yet under control and may also make your dad more susceptible to infections.
Also, it appears that both his kappa and lambda serum free light chain values are elevated, coupled with a high kappa/lambda ratio. This combination of events could "possibly" signal kidney impairment, which may be due to the multiple myeloma or possibly the pomalidomide itself (depending on the dose being used). What are his creatinine, BUN and eGFR numbers doing (all these numbers are used to identify any potential kidney impairment)?
Depending on what other treatments have been tried to control your dad's disease thus far, you might want to explore having your dad get into a clinical trial with one of the new monoclonal antibodies such as daratumumab (Darzalex) or elotuzumab (Empliciti). These drugs have often worked well with patients who don't respond to other treatments and often have less side effects associated with their use.
Welcome to the forum.
Are you based in the UK or elsewhere in Europe?
The key thing to look at with multiple myeloma are the trends and not so much just one snapshot in time. So, you would want to see what these numbers have done over time and with different treatments.
While the IgA number looks large, it isn't extremely high (assuming a normal range of 91-414 mg/dL) by multiple myeloma standards. The paraprotein reading is what is commonly referred to as the "M-spike", which in this case measures the amount of monoclonal IgA in your dad's blood. Given he has an IgA level of 1741 mg/dL, I'm guessing that the paraprotein level (M-spike) actually read out as 1.4 g/dL (1400 mg/dL or 14 g/L)
It also looks like his IgG and IgM levels are suppressed, which is a condition known as immunoparesis and signals that his disease isn't yet under control and may also make your dad more susceptible to infections.
Also, it appears that both his kappa and lambda serum free light chain values are elevated, coupled with a high kappa/lambda ratio. This combination of events could "possibly" signal kidney impairment, which may be due to the multiple myeloma or possibly the pomalidomide itself (depending on the dose being used). What are his creatinine, BUN and eGFR numbers doing (all these numbers are used to identify any potential kidney impairment)?
Depending on what other treatments have been tried to control your dad's disease thus far, you might want to explore having your dad get into a clinical trial with one of the new monoclonal antibodies such as daratumumab (Darzalex) or elotuzumab (Empliciti). These drugs have often worked well with patients who don't respond to other treatments and often have less side effects associated with their use.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High IgA and high lambda free light chain
Hi Multibilly,
Thanks very much for taking time to answer my questions. I was really happy to find this forum and have a place to ask questions.
I don't have his creatinine, BUN, or eGFR numbers. I will try to ask doctor next time.
I am from Hong Kong and it looks like pomalidomide is the latest treatment in the hospital at the moment. My father has tried bortezomib (Velcade), thalidomide, lenalidomide (Revlimid), and melphalan, but nothing seems to work well. He has taken these drugs for 4 years and they make him much weaker. He is currently taking pomalidomide, the 2nd cycle.
Thank you very much.
Best Regards,
Charlene
Thanks very much for taking time to answer my questions. I was really happy to find this forum and have a place to ask questions.
I don't have his creatinine, BUN, or eGFR numbers. I will try to ask doctor next time.
I am from Hong Kong and it looks like pomalidomide is the latest treatment in the hospital at the moment. My father has tried bortezomib (Velcade), thalidomide, lenalidomide (Revlimid), and melphalan, but nothing seems to work well. He has taken these drugs for 4 years and they make him much weaker. He is currently taking pomalidomide, the 2nd cycle.
Thank you very much.
Best Regards,
Charlene
3 posts
• Page 1 of 1