[jane]

M-spike - how do you calculate it?

by jane on Sat Jan 17, 2015 1:48 pm

Hi,

How can you calculate your M spike with the blood test results?

When I was diagnosed as IgG kappa (M-spike 1440 mg/dL = 1.44 g/dL = 14.4 g/L), my IgG results were 1349 mg/dL, which seems to be in the range.

Thank you.

[Multibilly]

Re: M-spike - how do you calculate it?

by Multibilly on Sat Jan 17, 2015 4:12 pm

Hi Jane,

First off, I'm not a doc, so please check with yours.

You shouldn't have to calculate the M-spike. It should be listed as a separate entry on your Serum Protein Electrophoresis (SPEP) test. But that value often times will be listed as a separate notation on the SPEP lab report and may be referred to as monoclonal protein or paraprotein or M-protein instead of as an "M-spike" on the report.

Also, note that the M-spike value won't always be listed on an online SPEP summary (if that's what you are looking at). You may have to look at the original paper copy of the lab report to find the value.

Also, the numbers you are citing don't sound quite right if you have a standard monoclonal gammopathy that is of an IgG type. Your serum M-spike simply can't be bigger than your quantified involved immunoglobulin value, unless you have two involved immunoglobulins that are in play (i.e., a biclonal gammopathy, where you have monoclonal IgG and another monoclonal immunogloblin, such as IgA). But, if that were the case, I would think there would be some sort of notation on your SPEP that would call this out, or the SPEP would list two separate abnormal bands.

Hope this makes sense and I'm not confusing you.

[jane]

Re: M-spike - how do you calculate it?

by jane on Sat Jan 17, 2015 5:53 pm

Thank you Multibility,

The report I have says "Myeloma IgG and kappa light chains". Does that mean I have two involved immunoglobulins?

[Multibilly]

Re: M-spike - how do you calculate it?

by Multibilly on Sat Jan 17, 2015 6:57 pm

Hi Jane,

You asked:

The report I have says "Myeloma IgG and kappa light chains". Does that mean I have two involved immunoglobulins?"

Not really. Most myeloma patients have one involved immunoglobulin, also known as a "heavy chain". These are IgG, IgA, etc. And one will also have a corresponding involved free light chain, which will be of kappa or lambda type. You simply have what is known as IgG kappa- type multiple myeloma. I happen to be IgG lambda. These are the two most common types of multiple myeloma.

My guess is that you aren't looking at the right lab reports or numbers to find the numbers you were asking about. Look at the lab report called Serum Protein Electrophoresis (SPEP) and see if you can find your M-spike value there - again, it is usually listed in some notes and they may call it something other than an M-spike. Then look at the lab report labeled "IgG Quant" (or titled something close to that) to find your total serum IgG.

Generally, the key items one tracks is the M-spike, the involved free light chain value (in your case, the kappa value), the free light chain ratio, calcium level, hemoglobin (Hgb), and creatinine level. These will tell you if you have any major changes in monoclonal activity or if you are potentially developing any "CRAB" issues.

You might want to read this handbook to get better acquainted with all this:

http://myeloma.org/pdfs/Patient%20Handbook.pdf

BTW, you may want to consider registering for this site and logging in when you post so that folks can see your earlier posts to better help you out.

Take care.

[jane84]

Re: M-spike - how do you calculate it?

by jane84 on Tue Jan 20, 2015 6:50 am

Thank you for the info Multi­billy. I think I will ask my haema­tol­ogist as I don't understand my blood test report. I won't send it to you as it is written in French !