[Ellen Harris]

Worried about post-transplant test results

by Ellen Harris on Thu Jan 29, 2015 1:45 pm

I am a little freaked out! My 100-day post-transplant blood work revealed at least two new clones, an M-spike of 0.1 g/dL (1 g/L), and elevated light chains.

I am IgA kappa light chain, and my numbers have been really low since transplant, with both kappa and lambda in the 6 to 8 range. I didn't get the printed report from this last set of blood tests, but my kappa was in the 20s and my lambda was in the 30s. The ratio was 0.60, which was actually lower than the previous ratios.

My stem cell transplant doctor says not to worry about the oligoclonal banding since they are different from my original myeloma type. I had seen this on my last few blood tests but there was no M-spike and the light chains and ratios were both normal.

I had my bone marrow biopsy yesterday so I won't know the results for a week to ten days. I am also just getting over the RSV virus and I am wondering if that may have affected the light chains. My doctor didn't think so.

Any words of wisdom? Thanks all.

[Mike F]

Re: Worried about post-transplant test results

by Mike F on Thu Jan 29, 2015 1:57 pm

For what it's worth, my M-spike went up and down for the first year or so after my transplant.

There was a month when it was undetectable, then it went to 0.1 g/dL, and then back and forth for another month or two. I think this was probably because the detection limit was right at 0.1 g/dL and for a period of time, the actual level was just above or just below that.

For the last eight months or so, it's stayed in the non-detectable range. My oncologist said that this is not terribly uncommon.

My understanding is that you don't need to worry until it starts trending upward for several months or if it suddenly goes way up.

[Ian]

Re: Worried about post-transplant test results

by Ian on Fri Jan 30, 2015 6:16 am

Hi Ellen,

I would second Mike's feedback. I'm curious, though, what your doctor had to say about your elevated free light chain levels. You said your doctor didn't think the levels were due to your recent infection, but did you get an alternative explanation or interpretation of the results?

When you do get the SPEP, IFE, and serum free light chain results, it probably would be helpful to post them. It's always hard to offer feedback based just on partial descriptions of the results.

I hope you continue to recover well from your infection and that the test results are just a temporary scare.

[Ellen Harris]

Re: Worried about post-transplant test results

by Ellen Harris on Fri Jan 30, 2015 11:15 am

Hi Ian,

Thanks for responding. I do have some more info, although not the SIFE.

My IgG was 822, IgA 84, IgM 185. My last IgM was only 30 only 3 weeks ago!

Kappa light chains were 2.3, lambda was 3.87. Ratio was 0.60. My doc said not to worry about the light chains because the ratio was good. She had no other explanation.

As I mentioned in my earlier post, I was IgA kappa light chain. My doc says it's just my immune system reconstituting itself, but it doesn't make sense to me that these numbers jumped within a three week period, especially the IgM.

Thanks for any input.