What does it mean to have more than one M-spike? When I was diagnosed I had one larger spike and two smaller spikes. The larger spike was IGa and the smaller ones are IGg.
Is this common? Does it signify anything?
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kjpoppit - Name: Kim Nelson
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept. 19th, 2013
- Age at diagnosis: 47
Re: More than one M-spike at diagnosis
First off, I'm not a pathologist or doctor, so verify all this with a specialist.
Since you are seeing this at the time of initial diagnosis and not after transplant, you "may" be seeing a secondary MGUS (which is a good thing, if you read this article).
http://bloodjournal.hematologylibrary.org/content/118/11/2985.full
The phenomenon of more than one spike showing up is apparently more common post- transplant (and is also a good thing prognosis-wise). You can easily find discussions about this post-transplant phenomena by googling "oligoclonal banding myeloma".
I'm just guessing at all this...hope this points you in the right direction.
Since you are seeing this at the time of initial diagnosis and not after transplant, you "may" be seeing a secondary MGUS (which is a good thing, if you read this article).
http://bloodjournal.hematologylibrary.org/content/118/11/2985.full
The phenomenon of more than one spike showing up is apparently more common post- transplant (and is also a good thing prognosis-wise). You can easily find discussions about this post-transplant phenomena by googling "oligoclonal banding myeloma".
I'm just guessing at all this...hope this points you in the right direction.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: More than one M-spike at diagnosis
I emailed IMF about my multi-spikes. This is what was explained to me. Don't know if this applies to everyone.
Two identical monoclonal bands is not a sign of a problem. He explained to me that sometimes the monoclonal protein polymerizes, or clumps together with another blood protein, and reads out on electrophoresis further down the spectrum as a separate spike. He said that in your case it is likely that the monoclonal protein from your MGUS has polymerized with the Von Willebrand glycoprotein. It does not mean you have myeloma. In fact, he said that seeing two identical bands like yours is often the sign of benign, long-term monoclonal gammopathy. Good news in its way
Two identical monoclonal bands is not a sign of a problem. He explained to me that sometimes the monoclonal protein polymerizes, or clumps together with another blood protein, and reads out on electrophoresis further down the spectrum as a separate spike. He said that in your case it is likely that the monoclonal protein from your MGUS has polymerized with the Von Willebrand glycoprotein. It does not mean you have myeloma. In fact, he said that seeing two identical bands like yours is often the sign of benign, long-term monoclonal gammopathy. Good news in its way
Re: More than one M-spike at diagnosis
Good question. This is called a biclonal gammopathy. You have two populations of abnormal plasma cells, one makes an IgA and the other makes an IgG. Not sure if you have other criteria for symptomatic myeloma but they both need to be monitored.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: More than one M-spike at diagnosis
I guess I am confused.
Is a secondary MGUS different from a biclonal gammopathy? And are both of these different than what the IMF put forward as an explanation (secondary band was due to polymerization with the Von Willebrand glycoprotein)?
Is a secondary MGUS different from a biclonal gammopathy? And are both of these different than what the IMF put forward as an explanation (secondary band was due to polymerization with the Von Willebrand glycoprotein)?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: More than one M-spike at diagnosis
I am also confused. How does my Factor VIII def. disorder play into that as well? Besides my AVWS. My spikes are of the same clone. But I now have multi urine spikes too. I give up! I just have to be happy to wake up breathing..lol Keep in trucking....
Re: More than one M-spike at diagnosis
I am diagnosed with multiple myeloma. I have the t4:14 chromosome issue. I was just curious about the additional M-spikes if it has any additional significance. I have a tendency to question everything I guess. Treatment is CyBorD at this time to be followed by an auto then allo stem cell transplant.
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kjpoppit - Name: Kim Nelson
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept. 19th, 2013
- Age at diagnosis: 47
Re: More than one M-spike at diagnosis
Hi everyone, I am trying to follow along here as well as this is interesting to me.
Bad Blood, are both of your spikes of the same Ig ?? i.e, both IgG or both IgA as opposed to kjpoppit who stated 2 spikes, one IgG and the 2nd is IgA ?
I ask as my IFE always reports "IGG Kappa Monoclonal Protein seen. Another faint IGG Kappa band seen." But I only have a single M-spike reported under the SPEP.
I have asked this question of my specialist and was confused by the answer(s) I received ...
1) could be due to the way the protein is migrating, or
2) I have 2 clonal populations, and the faint band does not have a measurable m-spike value.
So I would welcome some clarity on this issue as well. I have smoldering myeloma, not sure if this is significant or adds value.
Best to both of you.
Dana H.
Bad Blood, are both of your spikes of the same Ig ?? i.e, both IgG or both IgA as opposed to kjpoppit who stated 2 spikes, one IgG and the 2nd is IgA ?
I ask as my IFE always reports "IGG Kappa Monoclonal Protein seen. Another faint IGG Kappa band seen." But I only have a single M-spike reported under the SPEP.
I have asked this question of my specialist and was confused by the answer(s) I received ...
1) could be due to the way the protein is migrating, or
2) I have 2 clonal populations, and the faint band does not have a measurable m-spike value.
So I would welcome some clarity on this issue as well. I have smoldering myeloma, not sure if this is significant or adds value.
Best to both of you.
Dana H.
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DanaH - Who do you know with myeloma?: Myself, SMM as of 1/2012
- When were you/they diagnosed?: 1/2012
- Age at diagnosis: 54
Re: More than one M-spike at diagnosis
Hi Dana,
IgG lambda and additional faint IgG lambda. Only mgus. Urine is two (2) IgG lambda bands and one (1) free lambda light chains band. I find mixed information on that. Wish I had those answers for you.
IgG lambda and additional faint IgG lambda. Only mgus. Urine is two (2) IgG lambda bands and one (1) free lambda light chains band. I find mixed information on that. Wish I had those answers for you.
Re: More than one M-spike at diagnosis
Thank you bad blood for your reply and info that you shared, it was very helpful. Have a great weekend !
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DanaH - Who do you know with myeloma?: Myself, SMM as of 1/2012
- When were you/they diagnosed?: 1/2012
- Age at diagnosis: 54
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