Interestingly, my involved IgG has fluctuated a lot, but now seems to been trending downward after my autologous stem cell transplant (ASCT) last April, when it had consistently tested over 1,000 mg/dL prior to the transplant:
Before, After ———————————————————————————————————————————————>
1,150, 389 329 1,100 683 1,290 1,250 1,130 960
Normal: 700 - 1,600 mg/dL
But my IgM values have been trending up
Before, After ———————————————————————————————————————————————>
<5, <5 <5 <5 <5.3 <5.3 <5.96 <6.41 <11.5
Normal: 40 - 230 mg/dL
While my IgA values showed no real change from their consistently suppressed levels.
Before, After ———————————————————————————————————————————————>
<8, <8 <8 <8 <7.83 <7.83 <7.83 <7.83 <7.83
Normal: 70 - 400 mg/dL
Any one have insights he or she can share? Why would my involved immunoglobulin levels start showing declines (bad news?), while one of my other ones shows improvement (good news?).
Curious.
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MrPotatohead - Name: MrPotatohead
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: March, 2015
- Age at diagnosis: 65
Re: Variation in immunoglobulins after stem cell transplant
It occurs to me now that the decrease in my IgG immunoglobulins may be due to a decrease in healthy B plasma cells following my autologous transplant, which could be an effect of melphalan.
But that doesn’t explain the increase in my IgM levels.
I have not found much, in spite of extensive Googling, on what causes some people to recover to normal immunoglobulin levels after an autologous stem cell transplant, while others don’t.
But that doesn’t explain the increase in my IgM levels.
I have not found much, in spite of extensive Googling, on what causes some people to recover to normal immunoglobulin levels after an autologous stem cell transplant, while others don’t.
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MrPotatohead - Name: MrPotatohead
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: March, 2015
- Age at diagnosis: 65
Re: Variation in immunoglobulins after stem cell transplant
I, too, had a major decrease in my uninvolved immunoglobulins after autologous transplant, and my IgA and IgM never recovered. I'm not sure it's known why they recover in some people and not others.
I don't think the increase in your IgM numbers is necessarily significant.
Wish I knew more!
I don't think the increase in your IgM numbers is necessarily significant.
Wish I knew more!
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Arizonan - Name: Arizonan
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: April 2010
- Age at diagnosis: 54
Re: Variation in immunoglobulins after stem cell transplant
Mr PH,
Perhaps I'm missing something here.
Assuming you have IgG-type myeloma, you want your total IgG level to decline after any treatment, as long as it's due to a commensurate decrease in your IgG M-spike. Remember,
Total IgG = Healthy IgG + IgG M-spike.
You also want any suppressed immunoglobulins, such as your IgM or IgA, to increase. This would be reversing the phenomena of "immunoparesis", where your uninvolved immunoglobuins are suppressed. It looks like your IgM level is staging a comeback, which would be good news.
Perhaps I'm missing something here.
Assuming you have IgG-type myeloma, you want your total IgG level to decline after any treatment, as long as it's due to a commensurate decrease in your IgG M-spike. Remember,
Total IgG = Healthy IgG + IgG M-spike.
You also want any suppressed immunoglobulins, such as your IgM or IgA, to increase. This would be reversing the phenomena of "immunoparesis", where your uninvolved immunoglobuins are suppressed. It looks like your IgM level is staging a comeback, which would be good news.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Variation in immunoglobulins after stem cell transplant
You are right, Multibilly, as confirmed by my oncologist.
My apologies for the delay in my response. My oncologist was away on vacation, but he basically echoed what you say in your post at my last check up a few days ago.
I do have one question, however (which just occured to me after I posted this): I have light chain myeloma, and I thought that meant that my myeloma cells do not produce intact immunoglobulins, but only the light chains (kappa, in my case).
So would the myeloma cells contribute to the involved immunoglobulin level in cases of light chain disease? Perhaps the test for immunoglobulin levels counts light chains as well as intact molecules?
I have never shown an M-spike except with respect to elevated kappa free light chain levels, and Bence Jones protein in my urine.
Many thanks!
My apologies for the delay in my response. My oncologist was away on vacation, but he basically echoed what you say in your post at my last check up a few days ago.
I do have one question, however (which just occured to me after I posted this): I have light chain myeloma, and I thought that meant that my myeloma cells do not produce intact immunoglobulins, but only the light chains (kappa, in my case).
So would the myeloma cells contribute to the involved immunoglobulin level in cases of light chain disease? Perhaps the test for immunoglobulin levels counts light chains as well as intact molecules?
I have never shown an M-spike except with respect to elevated kappa free light chain levels, and Bence Jones protein in my urine.
Many thanks!
Last edited by MrPotatohead on Mon Oct 16, 2017 12:16 pm, edited 2 times in total.
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MrPotatohead - Name: MrPotatohead
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: March, 2015
- Age at diagnosis: 65
Re: Variation in immunoglobulins after stem cell transplant
Arizonan wrote:
Thank you, Arizonan.
Multibilly is correct. You should see a decrease in your involved immunoglobulin after successful treatment, because the cancerous plasma cells (the myeloma cells) contribute to the level of your involved immunoglobulin.
And any increase in your uninvolved immunoglobulins is good news, although, as you note, this increase does not always happen.
Thanks for your post.
I, too, had a major decrease in my uninvolved immunoglobulins after autologous transplant, and my IgA and IgM never recovered. I'm not sure it's known why they recover in some people and not others.
I don't think the increase in your IgM numbers is necessarily significant.
Thank you, Arizonan.
Multibilly is correct. You should see a decrease in your involved immunoglobulin after successful treatment, because the cancerous plasma cells (the myeloma cells) contribute to the level of your involved immunoglobulin.
And any increase in your uninvolved immunoglobulins is good news, although, as you note, this increase does not always happen.
Thanks for your post.
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MrPotatohead - Name: MrPotatohead
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: March, 2015
- Age at diagnosis: 65
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