I am 27, my first M-spike was when I was 26 (under a year ago). Doctors are still trying to determine if I have MGUS, but it is likely that I do. I am still brand new to this diagnosis, and don't know how to interpret results. I want to go in prepared with questions to my appointment with Memorial Sloane Kettering, where I'll be going for a second opinion.
Just to get a little peace of mind, I want to ask you all about the only weirdness that jumps out at me from my results. My IgG levels were stable around 950 mg/L from March 2016 when I was first tested, and then between November and January they went up to 1040 mg/L. My IgM and IgA levels both remained super stable.
I have no idea what this means or if this is a cause of concern. I'm still having a hard time getting my doctor to explain things fully, and I'm only just starting to educate myself (I was too freaked out when I first got the news).
I will transcribe my results in full when I have a chance.
Thank you!
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Re: IgG has gone up, but IgM & IgA stable
Hi Dearworld,
Are you sure you have right units of measure for your IgG? 950 mg/L = 95 mg/dL. The normal range for IgG is somewhere in the range of 700 - 1600 mg/dL (7,000 - 16,000 mg/L), or thereabouts, depending on the lab you use. I'm going to guess for now that you meant to say that your IgG was 950 mg/dL, not 950 mg/L.
But rather than focus on your IgA, IgM and IgA levels, you should be looking at the following:
- M-spike value from the serum protein electrophoresis test
- Kappa and lambda free light chain values from the serum free light chain assay.
- Creatinine, hemoglobin and calcium levels from your metabolic and CBC tests
- Results from your serum immunofixation test
What were the above values when your first diagnosed and what are they now?
Also, rather than saying that your IgA and IgM levels were stable, you might want to actually post those results to see if they are in a normal reference range. Note that it's helpful if you always include the reference ranges along with the units of measure when you post lab results.
Are you sure you have right units of measure for your IgG? 950 mg/L = 95 mg/dL. The normal range for IgG is somewhere in the range of 700 - 1600 mg/dL (7,000 - 16,000 mg/L), or thereabouts, depending on the lab you use. I'm going to guess for now that you meant to say that your IgG was 950 mg/dL, not 950 mg/L.
But rather than focus on your IgA, IgM and IgA levels, you should be looking at the following:
- M-spike value from the serum protein electrophoresis test
- Kappa and lambda free light chain values from the serum free light chain assay.
- Creatinine, hemoglobin and calcium levels from your metabolic and CBC tests
- Results from your serum immunofixation test
What were the above values when your first diagnosed and what are they now?
Also, rather than saying that your IgA and IgM levels were stable, you might want to actually post those results to see if they are in a normal reference range. Note that it's helpful if you always include the reference ranges along with the units of measure when you post lab results.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: IgG has gone up, but IgM & IgA stable
So I'm wondering whether or not I have MGUS.
The first time anything was detected was in March of 2016 when my blood work came back as follows:
Immunoglobins (serum)
IgG. 948 mg/dL
IgA. 284 mg/dL
IgM. 135 mg/dL
(All in range according to blood work)
Immunofixation (serum): A faint band in lambda is present against a dense polyclonal background. While this may represent a reactive/inflammatory process, a developing plasma cell disorder can not be excluded.
We tested again in August 2016 and results were as follows:
(“Call Test”)
Immunoglobins (serum)
IgG. 936 mg/dL
IgA. 272 mg/dL
IgM. 143 mg/dL
(All in range according to blood work)
Immunofixation (serum): No monoclonal proteins detected.
Then on the next page (unclear what test this was, but possibly under “protein electrophoresis”), it said: Faint band visible with overall polyclonal pattern in the gamma region. This may represent an inflammatory or acute phase response, but a developing plasma cell disorder can not be excluded.
Three months later, I was negative for proteins but my doctor did a bone marrow biopsy which came back normal. She didn’t seem to want to give up much information, didn’t call it an “M-spike” or anything, probably because I was presenting as extremely anxious, but when I asked her if I had MGUS, she said I did, since it had shown up once.
In January of 2018 I went to Memorial Sloan Kettering in my city and saw a specialist. They told me they thought the bone marrow biopsy was an aggressive approach, and that they did not feel I had MGUS because I had only shown monoclonal proteins on one test and never showed up again. They said my bone marrow biopsy looked like any one of theirs would have.
I wanted to take their word for it, but I worried that they were possibly nay-saying because of my age (I was 27). My GP (who is also an oncologist / hematologist) did not agree with them. On her advice, I continue to test every 3-6 months. I have been negative for everything every time since the August 2016 bloodwork. My last blood work was February 2018, and I am going back next week.
I do not feel that I understand the meaning of my initial results. Was it an M-spike? What kind of MGUS would this indicate? If I continue to be negative on every test over time, can I truly think of myself as not having MGUS?
I am beginning to feel symptoms which may be some kind of peripheral neuropathy which is what got me researching MGUS again. I am going to let me doctor know what I’ve been experiencing, and ask whether it could be related. But I really want to understand what my results indicate once and for all.
So, do I have MGUS or not?
Many thanks, and good luck.
The first time anything was detected was in March of 2016 when my blood work came back as follows:
Immunoglobins (serum)
IgG. 948 mg/dL
IgA. 284 mg/dL
IgM. 135 mg/dL
(All in range according to blood work)
Immunofixation (serum): A faint band in lambda is present against a dense polyclonal background. While this may represent a reactive/inflammatory process, a developing plasma cell disorder can not be excluded.
We tested again in August 2016 and results were as follows:
(“Call Test”)
Immunoglobins (serum)
IgG. 936 mg/dL
IgA. 272 mg/dL
IgM. 143 mg/dL
(All in range according to blood work)
Immunofixation (serum): No monoclonal proteins detected.
Then on the next page (unclear what test this was, but possibly under “protein electrophoresis”), it said: Faint band visible with overall polyclonal pattern in the gamma region. This may represent an inflammatory or acute phase response, but a developing plasma cell disorder can not be excluded.
Three months later, I was negative for proteins but my doctor did a bone marrow biopsy which came back normal. She didn’t seem to want to give up much information, didn’t call it an “M-spike” or anything, probably because I was presenting as extremely anxious, but when I asked her if I had MGUS, she said I did, since it had shown up once.
In January of 2018 I went to Memorial Sloan Kettering in my city and saw a specialist. They told me they thought the bone marrow biopsy was an aggressive approach, and that they did not feel I had MGUS because I had only shown monoclonal proteins on one test and never showed up again. They said my bone marrow biopsy looked like any one of theirs would have.
I wanted to take their word for it, but I worried that they were possibly nay-saying because of my age (I was 27). My GP (who is also an oncologist / hematologist) did not agree with them. On her advice, I continue to test every 3-6 months. I have been negative for everything every time since the August 2016 bloodwork. My last blood work was February 2018, and I am going back next week.
I do not feel that I understand the meaning of my initial results. Was it an M-spike? What kind of MGUS would this indicate? If I continue to be negative on every test over time, can I truly think of myself as not having MGUS?
I am beginning to feel symptoms which may be some kind of peripheral neuropathy which is what got me researching MGUS again. I am going to let me doctor know what I’ve been experiencing, and ask whether it could be related. But I really want to understand what my results indicate once and for all.
So, do I have MGUS or not?
Many thanks, and good luck.
Re: IgG has gone up, but IgM & IgA stable
If it were me, I would blend the advice of both doctors. That is, I would consider myself as not having MGUS, but that I may be on the brink of developing it. Getting re-tested every 3-6 months sounds a bit excessive under the circumstances (after all, the chances of you going from not having MGUS to active myeloma in 12 months are slim to none). While I'm certainly not a doctor, I might instead suggest just getting re-tested with a serum immunofixation, serum free light chain and serum electrophoresis test every year when you have your annual physical.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
4 posts
• Page 1 of 1