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M Protein change on Immunofixation
After three cycles of Rev/Dex, my husband's M protein changed from IgG Kappa to IgM Kappa. The oncologist did not mention this and we only picked it up when reviewing labs. Why did this happen?
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Lyn - Name: Lyn
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 69
Isotype switch from IgG to IGM
Has anyone experienced an isotype switch from IgG to IgM in the course of treatment and is this a negative event?
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Lyn - Name: Lyn
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 69
Re: M Protein change on Immunofixation
Dear Lyn,
Occasionally after a stem cell transplant new bands can transiently arise on the SPEP that are different than the patient's original M-protein. This is called oligoclonal reconstitution and reflects the re-development of the immune system after the transplant. Outside of this situation, however, I've never seen someone's M-protein change from IgG to IgM during therapy and suspect this is a typo or an error on the part of the lab running the test. I would repeat the testing before drawing any conclusions.
Occasionally after a stem cell transplant new bands can transiently arise on the SPEP that are different than the patient's original M-protein. This is called oligoclonal reconstitution and reflects the re-development of the immune system after the transplant. Outside of this situation, however, I've never seen someone's M-protein change from IgG to IgM during therapy and suspect this is a typo or an error on the part of the lab running the test. I would repeat the testing before drawing any conclusions.
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Dr. Adam Cohen - Name: Adam D. Cohen, M.D.
Beacon Medical Advisor
Re: M Protein change on Immunofixation
Dear Dr. Cohen,
Thank you SO much for responding to my question. The last three labs probably should have been included in my initial inquiry. Also, my husband is now on his fifth R/D cycle with a DFCI (Dr. Richardson) consultation scheduled for 8/15.
FYI - chromosome 13 deletion - Trisomy of chromosomes 1 and 11 -
.
Labs:
5/09/12 - Serum Immunofixation - IgG Kappa - 0.25 gm/dL - separate IgM - Kappa and Lambda light chains (too small to quantify).
Free Light Chain - Kappa - 3.18
Lambda - 1.83
Kapp/lamb Ratio - 1.74
6/14/12 - Serum Immunofixation - IgM Kappa - 0.16 gm/dL - separate IgM - Kappa and Lambda light chains (too small to quantify)
7/16/12 - Serum Immunofixation - IgM Kappa 0.17 gm/dL - separate monoclonal Lambda light chain (too small to quantify).
Lyn
Thank you SO much for responding to my question. The last three labs probably should have been included in my initial inquiry. Also, my husband is now on his fifth R/D cycle with a DFCI (Dr. Richardson) consultation scheduled for 8/15.
FYI - chromosome 13 deletion - Trisomy of chromosomes 1 and 11 -
.Labs:
5/09/12 - Serum Immunofixation - IgG Kappa - 0.25 gm/dL - separate IgM - Kappa and Lambda light chains (too small to quantify).
Free Light Chain - Kappa - 3.18
Lambda - 1.83
Kapp/lamb Ratio - 1.74
6/14/12 - Serum Immunofixation - IgM Kappa - 0.16 gm/dL - separate IgM - Kappa and Lambda light chains (too small to quantify)
7/16/12 - Serum Immunofixation - IgM Kappa 0.17 gm/dL - separate monoclonal Lambda light chain (too small to quantify).
Lyn
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Lyn - Name: Lyn
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: Sept 2011
- Age at diagnosis: 69
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