[LMF9]

Immunoparesis & risk of progression in MGUS

by LMF9 on Thu Mar 08, 2018 4:52 pm

Hello all,

I was recently diagnosed with MGUS based on:

• 0.9 IgG kappa m-protein
• 2.2 free light chain ratio (although the kappa and lambda are both within range, the "uninvolved" lambda is at the low end of the range, hence the slightly elevated ratio)
• Trace amounts of intact IgG in my urine (random sample, not 24-hour collection)

Other blood work, in particular creatinine, LDH, calcium, etc., is normal except I have a slightly below range RBC and hemoglobin, which I have had for over a decade due to being vegetarian (almost vegan).

I recently got another test result that is making me scared. My serum immunoglobulin levels (quantitative) show immunoparesis of IgA.

IgG - 1200 (range 613-1,295)
IgA - 27 (!) (range 69-309)
IgM - 69 (range 53-334)

Is it possible to have this sort of immunoparesis and not progress soon from MGUS to smoldering multiple myeloma, or some other less benign plasma cell disorder?

It seems to me that if I have suppressed activity of one of the immunoglobulins that something more sinister must be going on.

My current doctors have not done, and said they will not order, a bone marrow biopsy or scans. I am therefore seeking a second opinion.

Am I overreacting? I am just concerned that I may have smoldering multiple myeloma or may be at high risk.

I know the Mayo risk model doesn't include immunoparesis, but I believe there are other studies that say immunoparesis is a significant risk factor for progression.

I'd love to hear thoughts on the above.

Many thanks. I am trying to manage the stress. I sometimes wish that these tests had never been done. I feel FINE. I never get sick. My GP just decided to run the SPEP test because my WBC and RBC were low and now we are off to the races.

I am 57 year old female and am a very active person, by the way.

[robinblessed54]

Re: Immunoparesis & risk of progression in MGUS

by robinblessed54 on Thu Mar 08, 2018 11:48 pm

Hi LMF9,

I also recently was diagnosed with IgG lambda MGUS. Here are my numbers for my immunoglobulins:

IgG - 2,170
IgA - <6 (actually <1.23)
IgM - <17

I will be studying immunoparesis because my numbers are more suppressed than yours.

I have put in an email to my hematologist-oncologist for my M protein number. It wasn't anywhere in my blood work or my bone marrow biopsy.

I also have had 6 non-melanoma skin cancers removed over the last 15 years or so, basal cell, and I am a 3 1/2 year breast cancer survivor.

The Beacon had an interesting article about MGUS and multiple myeloma patients having secondary cancers such as breast, endocrine, and non-melanoma skin cancer. I am very curious if my skin and breast cancer are secondary? Since my MGUS was found by accident, I wonder how long I have had it?

Try not to worry, but get the tests and answers you need by any means possible.

Take care, Robin