[Anonymous]

Changes in post-transplant lab test results

by Anonymous on Fri Feb 07, 2014 4:07 pm

Hi everybody,

I was diagnosed with oligo-secretory IgG Kappa light chain myeloma a year ago. Now I am 9 months after stem cell transplant and in thalidomide maintenance.

When i was diagnosed SPEP was negative and the serum immunofixation was positive for oligoclonal IgG Kappa and lambda. Because i was secreting a lot of Kappa light chains (7200 at diagnosis) we were following like that.

The last month is happening something strange. The SPEP became positive with M spike of 0.8g/l that I never had, and the immunofixations is also positive for oligoclonal IgG Kappa and Lambda and monoclonal IgG K .

Could somebody have an explanation on that? Could be an indication of relapse?

[Dr. Jason Valent]

Re: Changes in post-transplant lab test results

by Dr. Jason Valent on Fri Feb 07, 2014 5:15 pm

If there has not been a change in the light chain assay, then I would just repeat the tests again in a month and follow the trend in the M-protein. It would be odd (but I suppose not impossible) to relapse with an intact immunoglobulin when it was not seen at diagnosis.

[Niki]

Re: Changes in post-transplant lab test results

by Niki on Sat Feb 08, 2014 11:28 am

Dear Dr. Valent,

Thank you very much. I understand you point. Actually the report of the immunofixation says, Monoclonal IgG Kappa Gammopathy with oligoclonal background. I was thinking if it could be some immune response. Thank you very much

Best regards
Niki

[Anonymous]

Re: Changes in post-transplant lab test results

by Anonymous on Tue Feb 11, 2014 1:39 pm

Hi Niki,

It could be a sign of immune reconstitution. I am thinking that you said that you are an IgG Kappa light chain myeloma patient , so i would expect the Kappa light chains to increase in case of a relapse. Also, i think that these oligoclonal background it should be a positive factor.

I think that some experts should step in and help you with this question. Take care!

Best regards
John

[Niki]

Re: Changes in post-transplant lab test results

by Niki on Thu Feb 13, 2014 4:04 am

Hello Everybody,

My doctor wanted me to repeat the tests, and the results were a little different.

The serum immunofixation results was the same with Monoclonal IgG K and oligoclonal background but the SPEP was negative for M-component this time. I think that the SPEP became negative alone, without me to be treated is a good sign, but the immunofixation scares me alot.

Best regards
Niki