[Annamaria]

IgG level & free light chain ratio rising

by Annamaria on Sat Mar 14, 2015 1:44 pm

Hi all.

After over two peaceful post-autologous stem cell transplant (ASCT) years, my IgG levels are rising, from 885 to 1055 mg/dL in three months. The spike looks higher on the chart. The kappa-lambda ratio is also rising, now at 16.70. All the other values are pretty much the same as before, and I feel perfectly well.

My doctor said that, if next time – in two months instead of three – the values remain stable, I will not have to do anything, but if they keep rising, I should start lenalidomide (Revlimid), which I never had because I chose not to do maintenance therapy.

Could these values remain stable for a long time, or just for a few months at most? Once things start moving, is a relapse approaching? Does anyone have experience with these sorts of changes, and whether or not the values can stabilize again?

Anxiously yours …

[NStewart]

Re: IgG level & free light chain ratio rising

by NStewart on Sat Mar 14, 2015 6:00 pm

AnnaMaria,

I was in a similar quandary when my numbers began to rise again following ASCT. Mine rose very slowly over the next 2 years before I was officially considered to be in a relapse. I also wasn't doing any maintenance therapy. My induction therapy was with Revlimid (lenalidomide) and dex, with good results. When I restarted treatment almost 3 years post transplant, I restarted on Revlimid and dex again since I had responded so well to it previously. My numbers came right down, and within 3 months they were at the same level that they had been immediately prior to transplant, 0.6 g/dl M-spike. I have remained stable at that level for 2 1/4 years with all of my other bloodwork improving gradually over that time.

It's good that your doctor is shortening the length of time between visits to keep track of what is going on. I have found that having more frequent appointments with my oncologist lessens the anxiety that I sometimes develop.

All the best to you,
Nancy in Phila

[Kevin J]

Re: IgG level & free light chain ratio rising

by Kevin J on Sun Mar 15, 2015 8:13 am

I have not had a SCT, but was in a CRD [carfilzomib (Kyprolis), Revlimid, and dex] clinical study and reached sCR. A little over a year ago, my IgA and M-protein started going up again. Similar to Nancy, I went on Revlimid and dex maintenance, and my levels came back down some and stabilized between 0.5 and 0.6 g/dl (5 and 6 g/l) since.

[Annamaria]

Re: IgG level & free light chain ratio rising

by Annamaria on Thu Mar 19, 2015 4:05 am

Thank you, Nancy and Kevin, for your replies. Your words made me feel better about my situation. I hope that, like in your case, Nancy, those numbers will rise slowly, and I hope that when the moment comes, Revlimid will do its job.