Hello Everyone!
Checking in with a quick update. The mass found on the CT/PET in February 2017 that I mentioned in a previous post turned out to be a very large soft tissue plasmacytoma. IgA kappa. Long story short, treatment was delayed for weeks due to insurance. Induction therapy with Revlimid, Velcade, and dexamethasone (RVD) took care of the plasmacytoma. Remission was officially declared in September 2017. Maintenance Revlimid was stopped in December 2017.
My monthly lab results up until May 2018 show IgG and IgM still slightly suppressed, but my IgA has been within normal limits for 6 months (in the 200's) until this month, June's results: IgA is 468.
I'm wondering if this is just a normal "creeping" fluctuation ?
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Dennis - Name: Dennis
- Who do you know with myeloma?: me
- When were you/they diagnosed?: March 2017
- Age at diagnosis: 64
Re: Blip up in IgA: does it mean anything?
Hi Dennis,
Glad to hear your extramedullary plasmacytoma is under control.
What is the normal range listed for your IgA? 469 mg/dL sounds like it is barely over the usual IgA normal limit, assuming a normal IgA range of 82-453 mg/dL for an adult (but all labs have different normal reference ranges, so it's important to list your lab's normal range). Also, what has your IgA m-spike from your serum electrophoresis test (assuming you are getting this test, which you may not if you have IgA-type myeloma) been doing over the past 18 months? Also, what have your free light chain numbers been doing over the past 18 months?
Glad to hear your extramedullary plasmacytoma is under control.
What is the normal range listed for your IgA? 469 mg/dL sounds like it is barely over the usual IgA normal limit, assuming a normal IgA range of 82-453 mg/dL for an adult (but all labs have different normal reference ranges, so it's important to list your lab's normal range). Also, what has your IgA m-spike from your serum electrophoresis test (assuming you are getting this test, which you may not if you have IgA-type myeloma) been doing over the past 18 months? Also, what have your free light chain numbers been doing over the past 18 months?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Blip up in IgA: does it mean anythin
Hi Multibilly,
The normal range my lab uses for IgA is 40-350 mg/dl.
December 2017 and February 2018, there was no M -spike. It never went over 0.1 g/dl
Light chains:
April 2016: Kappa 17.6mg/dl, ratio was 24.79
Feb 2018: Kappa 2.43, IgA band in beta region, faint kappa
February 2018 was the last time the light chains and M-spike were checked.
Last year my oncologist was completely shocked when the biopsy results showed the tumor was a plasmacytoma. I barely had an M-spike, was borderline anemic, and the tumor engulfed a large cluster of spinal lymph nodes; the doctor was convinced I had lymphoma! The plasmacytoma was very aggressive and grew to the size of a small watermelon fast! I also developed pleural effusion in both lungs.
I do wish the light chains, M-spike etc. were checked more frequently. My oncologist says he only checks twice a year. I'm not sure what the standard is, but not checking more frequently makes me very nervous!
The normal range my lab uses for IgA is 40-350 mg/dl.
December 2017 and February 2018, there was no M -spike. It never went over 0.1 g/dl
Light chains:
April 2016: Kappa 17.6mg/dl, ratio was 24.79
Feb 2018: Kappa 2.43, IgA band in beta region, faint kappa
February 2018 was the last time the light chains and M-spike were checked.
Last year my oncologist was completely shocked when the biopsy results showed the tumor was a plasmacytoma. I barely had an M-spike, was borderline anemic, and the tumor engulfed a large cluster of spinal lymph nodes; the doctor was convinced I had lymphoma! The plasmacytoma was very aggressive and grew to the size of a small watermelon fast! I also developed pleural effusion in both lungs.
I do wish the light chains, M-spike etc. were checked more frequently. My oncologist says he only checks twice a year. I'm not sure what the standard is, but not checking more frequently makes me very nervous!
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Dennis - Name: Dennis
- Who do you know with myeloma?: me
- When were you/they diagnosed?: March 2017
- Age at diagnosis: 64
Re: Blip up in IgA: does it mean anything?
Hi Dennis,
Wow, that sounds like a massive tumor that you were dealing with. I'm glad to hear that you got it under control.
Given you are dealing with extramedullary disease, I find it a bit peculiar that your doctor is so stingy about performing serum electrophoresis tests and serum free light chain assays. It's hard to say if your blip in your IgA is due to a polyclonal or monoclonal increase in your IgA without having the benefit of any serum electrophoresis test results. The only thing to be aware of when measuring IgA M-spikes is that they can sometimes to be overstated. This is why it's important to compare IgA M-spike readings with one's total IgA readings over time.
You might also consider asking your doctor to use the new Hevylite chain assay, which does a better job at tracking IgA disease burden than what a serum electrophoresis test can do.
Wow, that sounds like a massive tumor that you were dealing with. I'm glad to hear that you got it under control.
Given you are dealing with extramedullary disease, I find it a bit peculiar that your doctor is so stingy about performing serum electrophoresis tests and serum free light chain assays. It's hard to say if your blip in your IgA is due to a polyclonal or monoclonal increase in your IgA without having the benefit of any serum electrophoresis test results. The only thing to be aware of when measuring IgA M-spikes is that they can sometimes to be overstated. This is why it's important to compare IgA M-spike readings with one's total IgA readings over time.
You might also consider asking your doctor to use the new Hevylite chain assay, which does a better job at tracking IgA disease burden than what a serum electrophoresis test can do.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Blip up in IgA: does it mean anything?
Thank you, Multibilly, for the great information. Greatly appreciated. This site has been invaluable to my wife and me. At my next follow-up with the oncologist in September, I will mention the new Hevylite test.
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Dennis - Name: Dennis
- Who do you know with myeloma?: me
- When were you/they diagnosed?: March 2017
- Age at diagnosis: 64
Re: Blip up in IgA: does it mean anything?
Hello Dennis,
Ever since my diagnosis and first autologous stem cell transplant, my blood has been checked for at least M-spike every 3 months. Maybe it's different for plasmacytomas; and everyone is different. But having concerns, it's worth a call to your oncologist's office to request earlier evaluation.
Ever since my diagnosis and first autologous stem cell transplant, my blood has been checked for at least M-spike every 3 months. Maybe it's different for plasmacytomas; and everyone is different. But having concerns, it's worth a call to your oncologist's office to request earlier evaluation.
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jgilmore - Name: Yanell
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2009
- Age at diagnosis: 57
6 posts
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