[nowwhat]

IgG is up after 1 cycle of CyBorD?

by nowwhat on Sat Dec 03, 2016 1:29 pm

Hi everyone,

So my father has completed his 4th treatment of weekly cyclophosphamide, Velcade, and dexamethasone (CyBorD) and yesterday we met with the oncologist to go over his progress. So his M-spike and light chains had not posted yet, so those are pending, however his IgG went up from 2999 during diagnosis to roughly 31xx. The doctor said it's stable and not alarming as we need the M-spike and light chains to come in. (Which I totally get.)

My concern is why would his IgG increase? My father feels better than he did prior to his treatment, which his doctor said is an indication that treatment is working, but nonetheless it's concerning that his IgG has slightly increased.

Can anyone shed some light on the situation?

Thanks a bunch.

[Multibilly]

Re: IgG is up after 1 cycle of CyBorD?

by Multibilly on Sun Dec 04, 2016 7:43 am

In this situation, you really can't evaluate a very slight rise in the total IgG without also knowing the M-spike level. Remember,

Total IgG = IgG M-spike + Healthy (polyclonal) IgG

and the healthy (polyclonal) components of the various immunoglobulins fluctuate quite a bit from day to day. So, the rise in the total IgG could simply be due to a rise in the healthy IgG level while the M-spike may actually be going down. But you can't really know what's going on for sure with the total IgG without also knowing the M-spike level.

[nowwhat]

Re: IgG is up after 1 cycle of CyBorD?

by nowwhat on Tue Dec 06, 2016 1:52 pm

Hi Multibilly,

Thank you so much for your answer.

So we got some more results back. M-Spike is still pending

His lambda free light chains went up from 1250 (at diagnosis) to 1690
His kappa free light chains went up from 1.43 to 1.60
Kappa lambda ratio was 0.00 and still is 0.00

He was on antibiotics for slight infection and I don't know if that has anything to do with his numbers.

He feels so much better since getting on the treatment so I don't know why the lambda came back higher.

Thanks!