I am almost 80 days post transplant. I just received my latest serum immunofixation results which surprised me.
I have IGA kappa light chain disease. The immunifixation reads "a faint band of IgG lambda cannot be excluded." No mention of IgA kappa. Kappa is 7, lambda is 8. I have read on the forum that the emergence of another low level m protein can be a positive sign?
There is no m spike. IgG is only immunoglobin in normal range; A and M are low.
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Re: Immunofixation shows possible new IgG lambda band
Ellen,
I'm not a doc, so check all this with yours.
But it indeed sounds like you could be experiencing this banding phenomena (although the IFE is simply saying there "might" be a faint band). In any case, if a new type of M-spike does pop up, this is not a bad thing at this stage.
"Secondary MGUS pre- and post-transplant?," Beacon forum disc. started Aug 28, 2014
I also understand that it is not uncommon to have some of your immunoglobulins be suppressed post-transplant. This is known as immunoparesis and it can occur as your immune system reconstitutes itself. It will likely resolve itself over time.
Again, check all this out with your doc. Take care.
I'm not a doc, so check all this with yours.
But it indeed sounds like you could be experiencing this banding phenomena (although the IFE is simply saying there "might" be a faint band). In any case, if a new type of M-spike does pop up, this is not a bad thing at this stage.
"Secondary MGUS pre- and post-transplant?," Beacon forum disc. started Aug 28, 2014
I also understand that it is not uncommon to have some of your immunoglobulins be suppressed post-transplant. This is known as immunoparesis and it can occur as your immune system reconstitutes itself. It will likely resolve itself over time.
Again, check all this out with your doc. Take care.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Immunofixation shows possible new IgG lambda band
Thanks, Multibilly! I did a little research and found the articles you mentioned. I never had much of an M-spike because I am light chain, so I am not sure this is the same thing, but I will check it out with my doc.
I appreciate your input. You add so much to the forum with your knowledge of the technical stuff.
I appreciate your input. You add so much to the forum with your knowledge of the technical stuff.
Re: Immunofixation shows possible new IgG lambda band
Thanks Ellen,
BTW, note this comment on light-chain-only multiple myeloma and oligoclonal banding:
"The incidence of oligoclonal bands was most frequent in non-IgG isotype, particularly in light chain only myeloma"
N Tovar et al., "Natural History And Prognostic Impact Of Oligoclonal Humoral Response In Patients With Multiple Myeloma After Autologous Stem Cell Transplantation: Long-Term Results From A Single Institution," Haematologica, July 2013.
Abstract:
The emergence of an oligoclonal humoral response, resulting in the appearance of a different serum M-protein to that observed at diagnosis is a well-recognized event after autologous stem cell transplantation in multiple myeloma in complete response, and it has been considered to be a benign phenomenon. The aim of the present study was to investigate the incidence, biological characteristics and prognostic value of the oligoclonal bands in patients with myeloma who underwent autologous transplantation at our institution in the last 18 years.
We proceed with a retrospective systematic review of all serum and urine immunofixation studies performed in the 211 patients with multiple myeloma who underwent melphalan-based autologous transplantation.
Oligoclonal bands were observed in 34% of the patients, with a significantly higher prevalence with the use of novel agents versus conventional chemotherapy in induction (63% vs. 22%; P=0.0001). The incidence of oligoclonal bands was most frequent in non-IgG isotype, particularly in light chain only myeloma. The oligoclonal phenomenon was almost exclusive to patients in complete remission compared to other degrees of response (87% vs. 13%; P=0.0001), and lasted for a median of 1.35 years, persisting during follow up in all patients except in those who relapsed.
In prognostic terms, the presence of oligoclonality resulted in a significantly longer progression-free and overall survival. Patients with oligoclonal humoral response lasting for more than one year after transplantation had a significantly longer clinical progression-free and overall survival than those with shorter duration (P=0.008 and P=0.0001, respectively), likely reflecting the importance of a robust humoral immune response.
BTW, note this comment on light-chain-only multiple myeloma and oligoclonal banding:
"The incidence of oligoclonal bands was most frequent in non-IgG isotype, particularly in light chain only myeloma"
N Tovar et al., "Natural History And Prognostic Impact Of Oligoclonal Humoral Response In Patients With Multiple Myeloma After Autologous Stem Cell Transplantation: Long-Term Results From A Single Institution," Haematologica, July 2013.
Abstract:
The emergence of an oligoclonal humoral response, resulting in the appearance of a different serum M-protein to that observed at diagnosis is a well-recognized event after autologous stem cell transplantation in multiple myeloma in complete response, and it has been considered to be a benign phenomenon. The aim of the present study was to investigate the incidence, biological characteristics and prognostic value of the oligoclonal bands in patients with myeloma who underwent autologous transplantation at our institution in the last 18 years.
We proceed with a retrospective systematic review of all serum and urine immunofixation studies performed in the 211 patients with multiple myeloma who underwent melphalan-based autologous transplantation.
Oligoclonal bands were observed in 34% of the patients, with a significantly higher prevalence with the use of novel agents versus conventional chemotherapy in induction (63% vs. 22%; P=0.0001). The incidence of oligoclonal bands was most frequent in non-IgG isotype, particularly in light chain only myeloma. The oligoclonal phenomenon was almost exclusive to patients in complete remission compared to other degrees of response (87% vs. 13%; P=0.0001), and lasted for a median of 1.35 years, persisting during follow up in all patients except in those who relapsed.
In prognostic terms, the presence of oligoclonality resulted in a significantly longer progression-free and overall survival. Patients with oligoclonal humoral response lasting for more than one year after transplantation had a significantly longer clinical progression-free and overall survival than those with shorter duration (P=0.008 and P=0.0001, respectively), likely reflecting the importance of a robust humoral immune response.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Immunofixation shows possible new IgG lambda band
Thanks for the article, very interesting. Based on the info, I hope the new band develops and stays awhile!
Re: Immunofixation shows possible new IgG lambda band
My husband also had a 'banding' post transplant. He is IgG lambda light chain only. Banding was IgG kappa with a small M spike. Went away after 9 months.
All the best with your post transplant recovery, and happy new year. I agree - Multibilly adds a ton of good information :- )
All the best with your post transplant recovery, and happy new year. I agree - Multibilly adds a ton of good information :- )
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philatour - Who do you know with myeloma?: spouse
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