First of all, I want to thank Dr. Cohen for clarifying biochemical vs. clinical progression in this discussion thread, and thank you everyone else for the great insights as usual.
I had one question regarding disease progression in smoldering myeloma that is probably best to put in its own thread.
My mom has tests every 3 months. In her latest test (I just got the results), the IgG registered a significant rise (from 2900 to 3900!) but the "paraprotein band" has risen from 2.60 g/dL to 2.88 g/dL, and total serum protein is exactly the same at 8.7 g/dL.
Kappa/lambda FLC ratio is almost the same, somewhat lower.
Is the rise in IgG sufficient to imply that biochemical progression has occurred in my mother's case, or is the paraprotein band what matters? (There are no CRAB symptoms yet).
What does it mean to have similar monocolonal band sizes but such a big increase in IgG?
Thank you very much in advance for any insight.
Forums
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Re: Rise in IgG, stable M-spike - sign of progression?
Hi smyrna,
The M-spike is what you want to watch in terms of whether or not your mother is progressing.
Others here can correct me if I'm wrong, but I believe the way to think about it is that the total IgG is made up of two parts ... the monoclonal IgG, which is being measured by your mother's M-spike, and the normal IgG.
So, if your mother's IgG has increased a lot, but her M-spike is more or less stable, it's the amount of normal IgG that is going up that is causing the increase in the total IgG. And there are a lot of different things other than myeloma that can cause an increase in the normal IgG ... an infection of some sort, or a flare up in autoimmune activity, are some examples, if I'm not mistaken.
So you shouldn't be worried about the increase in the total IgG if the M-spike is holding steady. However, you may want to talk with your mom's doctor about what the cause of the increase in the total IgG might be and whether it should be looked at closer.
Hope this helps. Please let us know if you find out anything more about this.
The M-spike is what you want to watch in terms of whether or not your mother is progressing.
Others here can correct me if I'm wrong, but I believe the way to think about it is that the total IgG is made up of two parts ... the monoclonal IgG, which is being measured by your mother's M-spike, and the normal IgG.
So, if your mother's IgG has increased a lot, but her M-spike is more or less stable, it's the amount of normal IgG that is going up that is causing the increase in the total IgG. And there are a lot of different things other than myeloma that can cause an increase in the normal IgG ... an infection of some sort, or a flare up in autoimmune activity, are some examples, if I'm not mistaken.
So you shouldn't be worried about the increase in the total IgG if the M-spike is holding steady. However, you may want to talk with your mom's doctor about what the cause of the increase in the total IgG might be and whether it should be looked at closer.
Hope this helps. Please let us know if you find out anything more about this.
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Jonah
2 posts
• Page 1 of 1