[Bleigh3462]

Can it be myeloma with a negative immunofixation test?

by Bleigh3462 on Sat Nov 26, 2016 8:10 pm

I see my hematologist again next Friday, but just have some questions as I'm new to this.

I had an abnormal SPEP with elavated gamma globulin raised, absolute mono, slight anemia, my CRP leval was 59.6, and my sed rate of 90.

Also kappa qnt free light chain was 5.75 and the max on my test was 1.94.
Normal lambda qnt free light chain of 2.46, max 2.63 range
And kappa lambda ratio of 2.34, max of 1.65.

But a negative IFE test for monoclonal.

Does this look like multiple myeloma? Thank you.

[Multibilly]

Re: Can it be myeloma with a negative immunofixation test?

by Multibilly on Sun Nov 27, 2016 8:44 am

Hi Bleigh3462,

Welcome to the forum.

First off, I'm not a doctor, so please let your doctor guide you in this.

Having a negative serum immunofixation (IFE) doesn't completely rule out multiple myeloma (or a pre-cancerous stage such as MGUS) since there is a small percentage of myeloma patients (1-4%) that have what is called nonsecretory myeloma. With nonsecretory multiple myeloma, an SPEP, UPEP and IFE cannot be used to register and track the disease, but often times the disease can still be tracked through irregularities in the serum free light chain assay results.

But I wouldn't jump to the conclusion that you have nonsecretory multiple myeloma and would simply let the hematologist look at your overall medical picture to arrive at a diagnosis. What prompted your doctor to run an SPEP in the first place?

[Bleigh3462]

Re: Can it be myeloma with a negative immunofixation test?

by Bleigh3462 on Sun Nov 27, 2016 7:17 pm

I went to my family doctor to see why my body hurts so bad and my ESR came back high and my CRP was high, so he sent me to a rheumatologist, who sent me to a hematologist because his tests for rheumatoid arthritis and lupus were negative.

[Multibilly]

Re: Can it be myeloma with a negative immunofixation test?

by Multibilly on Sun Nov 27, 2016 8:22 pm

Well, while it's not much consolation, I think it is good that a rheumatologist has already ruled out a couple of major autoimmune diseases. If your hematologist suspects that you have some plasma cell disorder without any M-protein registering on an IFE, I'm guessing that he/she will want to order up a bone marrow biopsy to help get to the bottom of all this. Let us know how things turn out on Friday and good luck.

[Bleigh3462]

Re: Can it be myeloma with a negative immunofixation test?

by Bleigh3462 on Mon Nov 28, 2016 5:18 am

Thank you so much for answering my questions and, as I have read, this is a hard disease to understand ... lol Lots of different circumstances.