[rmcarch]

Implications of oligoclonal bands in multiple myeloma

by rmcarch on Thu Aug 18, 2011 1:57 am

My recent serum immunofixation results contained the following statement:

"There is a faint abnormal band in the mid gamma region, too low to be accurately estimated by densitometry. Immunofixation identifies this band as an IgG kappa protein, which likely represents an olioclonal band."

My doctors have characterized the IgG olioclonal band as not associated with my IgA Kappa Meyeloma and thus may represent a reconstitution of my immune system and could be indicative of a robust response . Exactly to what qualitative or quantitative effect is unknown. Although I find positive recent studies mentioning olioclonal bands, no mention is made of olioclonal bands in the various definitions of levels of response to therapy.

Can anyone offer comments on this subject?

Does this type of serum immunofixation result predict a strong response to therapy and thus connote a more positive outlook?

Could identification and tracking and perhaps treatments geared to achieving olioclonal bands contribute to standard protocols for myeloma treatment?

[Dr. Ken Shain]

Re: Implications of oligoclonal bands in multiple myeloma

by Dr. Ken Shain on Mon Aug 22, 2011 6:58 pm

Sorry for the delay in response. My experience with oligoclonal bands has not yet yielded any correlation between their presence and improved (or poor) response. Typically, oligoclonal bands do represent a reconstituting immune system are noted several months after transplant, can be present for for multiple months, and resolve spontaneously. I have to admit this is an intriguing question and I don't know if it has been directly examined.

These bands do bear monitoring. As you're physicians have noted, the patient oligoclonal bands represent a transient immune reconstitution phenomenon not relapse of disease. It is especially important to note to your initial diagnosis of IgA kappa monoclonal paraprotein and the current presence of an IgG kappa oligoclonal band.