[btdyq5]

Hyperimmunization and plasma cell disorders

by btdyq5 on Sat Sep 17, 2016 7:46 pm

Hello,

My GP referred me to a hematologist when I started having problems with coagulation like easy bruising and purpura and a delayed partial thromboplastin time. My platelet count is normal. When the nurse at the hematologist's office was going through the big list of symptom questions they latched onto the fact that I have chronic back pain, carpal tunnel syndrome, and nerve problems for the past year. The hematologist said he thought it'd be a good idea to test me for "paraproteins" and ordered blood and urine tests looking for M-spikes and monoclonal proteins.

All the tests came back normal except for a blood test called free light chains, which showed that my ratio was a little high (2.4), but neither of the levels of either light chain were actually too high. The doctor said he thought I must not have one of these diseases, but in the time period between testing and my follow up appointment I did some googling on the topic of paraprotein disorders and found out that these diseases don't always show up on the tests that were done.

Worse still, I came across a series of research studies that showed that people who have been hyperimmunized previously are at a strongly increased risk of monoclonal gammopathy of undermined significance (MGUS) and also that a similar disease called amyloidosis can be induced reliably in animals through repeated immunization. I'll attach a link to one such study that shows that army folks who were hyperimmunized had a 3-fold increased risk of MGUS:

Pittman, PR, et al., "Long-term health effects of repeated exposure to multiple vaccines," Vaccine, Dec 2004 (abstract; full-text PDF)

I have a history of having to receive several series of pre and post exposure rabies vaccines, so I definitely qualify as being hyperimmunized.

Is there any other information available about the role of vaccination in the development of myeloma or related diseases? Does anyone here feel their condition might trace back to too many vaccinations?

Given my unique circumstances and increased risk, should I be badgering the doctor to keep digging, or should I take him at his word that I don't have this disease?

Thank you in advance for any advice.

[MrPotatohead]

Re: Hyperimmunization and plasma cell disorders

by MrPotatohead on Sun Sep 25, 2016 10:27 pm

Hi btdyq5,

I can easily understand why you are concerned.

I have not heard of any association between multiple vaccinations and an increased frequency of MGUS, but the study you cite is certainly interesting. Thank you very much for posting it, You mention that it is one of several that you have found. Can you identify one or more of the others?

As for your specific case, for your free light chain (FLC) results, are the units your results were reported in mg/dL or mg/L?

Also, did the tests you had include serum and urine protein electrophoresis tests in addition to the free light chain tests? Were you also tested for calcium levels and did you have a complete blood count and chemistry tests? Finally, have you had an MRI of your back? If the answer is yes to all of the above and results were all normal, it seems unlikely to me that you have either MGUS or multiple myeloma or amyloidosis. Still, the free light chain ratio is a concern.

However, I am not a doctor, and have had no medical training whatsoever.

if you are really worried (which I think would be a natural reaction), I suggest seeking a second opinion from a multiple myeloma specialist. Some of the participants on this forum may be able to help you connect with one if you can provide your location.

Good luck and best regards.

[btdyq5]

Re: Hyperimmunization and plasma cell disorders

by btdyq5 on Mon Sep 26, 2016 9:24 pm

Hi there and thanks very much for your reply.

To address your questions:

1) I'll link to a few of the other studies included in this longitudinal series of studies of hyper­immunized individuals. I don't think a full-text option is available for the first one:

Peeler, RN, et al., "Intensive Immunization of Man: Evaluation of Possible Adverse Consequences," Annals of Internal Medicine, July 1, 1965 (abstract)

This one should be readable in its entirety. It states very clearly a known link between hyper­immunization and amyloidosis in experimental animals:

National Research Council (U.S.). Committee on the Effects of Multiple Immunizations, Effects of Long-term Immunization with Multiple Antigens: Final Report, National Academies, 1980 (full text)

2) For the free light chains, the units of measure are mg/L. My most recent results are as follows:

Kappa: 9.39 mg/L (3.30 - 19.40 mg/L)
Lambda: 3.85 mg/L (5.71 - 26.30 mg/L)
Kappa / lambda ratio: 2.44 (0.26 - 1.65)

They have varied a bit over the past few months, with the kappa / lambda ratio fluctuating any­where from 2.31 in June to 2.75 in July.

3) In addition to the free light chains, I have in fact had serum and 24-hour urine electro­phoresis and immunofixation tests, CBC, metabolic panel (calcium, kidney, liver, etc), an MRI of my back and a bone marrow biopsy. Everything came back normal with the exception of increased IgA, decreased IgG, and a herniated disk in my back (due to weightlifting most likely).

[MrPotatohead]

Re: Hyperimmunization and plasma cell disorders

by MrPotatohead on Tue Sep 27, 2016 8:54 am

Hi btdyq5,

Thanks very much for the additional info. I found the additional studies on immunization and high monoclonal protein very interesting, but am puzzled by a lack of any explanation. Certainly there is much in your tests that point away from multiple myeloma or MGUS.

The abnormal FLC ratio in your case does seem to me to be due to some mechanism of myelo­suppression (resulting in suppressed lambda values) rather than MGUS or multiple myeloma.

I also have a low free light chain ratio due to low lambda values. In my case, my oncologist believes my myelosuppression is due to side effects from myeloma treatment, which included Kyprolis and Cytoxan.

You have gotten some very good advice from Forum luminaries like Multibilly, and I am afraid I have little to add to the information that they have already given you, except not to panic. Getting to the bottom of this may require consults with more than one myeloma expert, and hence some patience.

I hope you find the answer soon!