[Perseverance]

Is hypogammaglobulinemia a sign of residual disease?

by Perseverance on Thu Sep 08, 2011 11:13 pm

Is a suppressed level of all three (IgG, IgA, and IgM) a sign of residual disease? Or, is it indicative something else? Doctors declared a stringent complete response (sCR) a few months ago, and I'm wondering if these levels will slowly normalize or if they will remain suppressed.

[Dr. Ken Shain]

Re: Is hypogammaglobulinemia a sign of residual disease?

by Dr. Ken Shain on Fri Sep 09, 2011 8:38 am

Based on your stringent complete response, your disease is well controlled and likely remains so after three months of therapy . Quantitative immunoglobulins may also be suppressed with therapy as they are a reflection of your normal immune system. As such, it may take sometime for immunoglobulins to recover (especially if multiple agents and/or transplant were involved).

Without specific details of therapy (chemo, novel agents, and/or transplant), timing, or drugs it is difficult to comment further. However, if your quantitative immunoglobulins had initially recovered and are now decreasing in the absence of therapy, it would raise some concerns. It is always best to err on the side of caution, but from the data you provided it sounds like you may still be recovering. Please have an enjoyable weekend and let us know if we can help further.

[Perseverance]

Re: Re: Is hypogammaglobulinemia a sign of residual disease?

by Perseverance on Fri Sep 09, 2011 1:25 pm

The treatment was CyBorD (cyclophosphamide, Velcade, and dexamethasone) + stem cell transplant + Revlimid maintenance. Complete remission was achieved after 2 cycles of CyBorD. The immunoglobulins have slowly recovered (IgG from 405-445; IgM from 24-35; the effected immunoglobulin IgA has remained in a range between 10-13).

Thank you, doctor.