[Ellen Harris]

Changes in post-transplant free light chain levels

by Ellen Harris on Thu Mar 05, 2015 9:52 am

An unexpected development. I am nearly 5 months post auto stem cell transplant. I went into transplant in complete remission (CR), came out in CR, and was upgraded very recently to stringent CR.

I have had some oligoclonal banding. Originally, I was IgA kappa light chain. Banding was IgM and IgG, both kappa and lambda. Light chain ratio was normal; once they both rose slightly to kappa 26 and lambda 36; next time, it normalized.

No M-spike prior to transplant. With the banding, M-spike went to 0.1 g/dL, then 0.5 g/dL, then faint.

Three weeks ago, I had a sudden dental infection, which necessitated 2 extractions and 2 rounds of Zithromax (azithromycin). A few days after the last dose of Zithromax, I had bloodwork. This time, kappa was 8 and lambda was 50! I don't know whether there was an M-spike (either I didn't receive complete results, or it was not checked).

Any thoughts about this?

Thanks for any input.

[Multibilly]

Re: Changes in post-transplant free light chain levels

by Multibilly on Thu Mar 05, 2015 5:49 pm

Hi Ellen,

Infections can cause free light chain values to rise. With everything currently going on with you (your immune system still reconstituting itself, oligoclonal banding, and now an infection), I doubt your doc is going to worry about this one test result and will suggest just getting re-tested in the near future. At least that is my guess as a layman.

[Ellen Harris]

Re: Changes in post-transplant free light chain levels

by Ellen Harris on Thu Mar 05, 2015 7:04 pm

Hi Multibilly,

Thanks so much for your input. You read my doc's mind! He said almost the same thing!

I am always on edge these days! Ellen

[Dr. Edward Libby]

Re: Changes in post-transplant free light chain levels

by Dr. Edward Libby on Thu Mar 05, 2015 10:04 pm

Hello Ellen,

As usual, I am in agreement with Multibilly.

You can rest easy!

[Ellen Harris]

Re: Changes in post-transplant free light chain levels

by Ellen Harris on Thu Mar 05, 2015 11:33 pm

Thank you so much Dr. Libby!