Hello,
I have been on Revlimid 25 mg 21 days on, with 7 off, and dexamethasone once per week @ 40 mg for the last 6 months. My lab results have been very good with the current treatments.
I see my oncologist once per month after he receives my lab results. Today he said that the lab is suggesting that they change the testing from the SPEP [serum protein electrophoresis] to IFE [immunofixation electrophoresis] because the IFE is more sensitive for the identification of smaller amounts of M-proteins.
Has anyone had their testing changed when the protein has lowered to a point that the SPEP tests changed to IFE testing?
Castaway
Forums
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Have you been switched from SPEP to IFE lab testing?
Curious...
What's the "Wobble" with IFE ?
I'd hate to be ruminating for 3 months about "deteriorations" , due to a "Wobble" in test parameters that are essentially WNL.
What's the "Wobble" with IFE ?
I'd hate to be ruminating for 3 months about "deteriorations" , due to a "Wobble" in test parameters that are essentially WNL.
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Rneb
Re: Have you been switched from SPEP to IFE lab testing?
Rneb,
Sorry, but I don't understand your comment about "Wobble" with IFE. All I know is the lab suggested to change the testing to IFE for there lab reports since my levels have been coming down to a point at which the SPEP is not as accurate as the IFE. And I just thought that I would ask if others had this happen.
Really not sure about the IFE and my oncologist doesn't think we need to go that route but is going by the lab's suggestion.
Thank You, Castaway
Sorry, but I don't understand your comment about "Wobble" with IFE. All I know is the lab suggested to change the testing to IFE for there lab reports since my levels have been coming down to a point at which the SPEP is not as accurate as the IFE. And I just thought that I would ask if others had this happen.
Really not sure about the IFE and my oncologist doesn't think we need to go that route but is going by the lab's suggestion.
Thank You, Castaway
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Have you been switched from SPEP to IFE lab testing?
Every Lab, as part of certification processes, has to demonstrate a range of ready reproduce-able numbers produced by it's standardized process, given a known quantity as measured against--ie. a standard.
It is often referred to as..."The Wobble".
In Law, it is often called a "Daubert" Issue. It has to do with reliability of results....and common scientific "acceptance".
I do not know the range of allowable "range" for IFE testing.
I do know the SPEP range.
It occurred to me that if the range was very narrow--that is one set of values one can rely upon.
If the range is wider--then interpretation of treatment can be skewed somewhat--especially if one goes 3-6 months between tests.
( ie--does this test/ wobble indicate my proteins are increasing ? Decreasing ? Are gone ? What else can I freak out about ? Ignore ? etc.)
As multiple myeloma is very much a "Monitor the Serum / Protein(s)" process--to gauge effectiveness of drugs/treatment, knowing the Wobble ( range) is ....kind of important.
It is often referred to as..."The Wobble".
In Law, it is often called a "Daubert" Issue. It has to do with reliability of results....and common scientific "acceptance".
I do not know the range of allowable "range" for IFE testing.
I do know the SPEP range.
It occurred to me that if the range was very narrow--that is one set of values one can rely upon.
If the range is wider--then interpretation of treatment can be skewed somewhat--especially if one goes 3-6 months between tests.
( ie--does this test/ wobble indicate my proteins are increasing ? Decreasing ? Are gone ? What else can I freak out about ? Ignore ? etc.)
As multiple myeloma is very much a "Monitor the Serum / Protein(s)" process--to gauge effectiveness of drugs/treatment, knowing the Wobble ( range) is ....kind of important.
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Rneb
Re: Have you been switched from SPEP to IFE lab testing?
Castaway,
Don't you already get BOTH an IFE and an SPEP as part of your routine testing? A serum IFE is a qualitative test and is indeed more accurate at detecting if there is any monoclonal protein present in your serum (and tells you what kind it is). But it doesn't tell you the quantity of monoclonal protein like an SPEP would (i.e. your M-Spike value). I would think you would really want both tests (and I thought just about everyone that is being routinely monitored already gets both of these tests).
Don't you already get BOTH an IFE and an SPEP as part of your routine testing? A serum IFE is a qualitative test and is indeed more accurate at detecting if there is any monoclonal protein present in your serum (and tells you what kind it is). But it doesn't tell you the quantity of monoclonal protein like an SPEP would (i.e. your M-Spike value). I would think you would really want both tests (and I thought just about everyone that is being routinely monitored already gets both of these tests).
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Have you been switched from SPEP to IFE lab testing?
At our center, we still get both the SPEP and immunofixation for monitoring, although if the SPEP shows no M-protein, it could be reasonable to then follow with the immunofixation, although I always prefer to have the quantitative measurement of the M-protein.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Have you been switched from SPEP to IFE lab testing?
Dr. Valent, Multibilly, and Rneb,
Thank you all for the information. I have been trying to get an insurance approval to have a harvest, storage, and transplant at USC Norris in Southern California. I just got word that I am covered. What a load off my shoulders. It's like not knowing if Revlimid was going to be covered 6 months ago. It was covered also.
One step at a time. Now I can move on.
All your information is very much appreciated and I will not only speak with my oncologist where I live about this information, but I will also talk with the doctor and nurse at USC Norris about testing for my labs with SPEP and IFE.
Castaway
Thank you all for the information. I have been trying to get an insurance approval to have a harvest, storage, and transplant at USC Norris in Southern California. I just got word that I am covered. What a load off my shoulders. It's like not knowing if Revlimid was going to be covered 6 months ago. It was covered also.
One step at a time. Now I can move on.
All your information is very much appreciated and I will not only speak with my oncologist where I live about this information, but I will also talk with the doctor and nurse at USC Norris about testing for my labs with SPEP and IFE.
Castaway
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Have you been switched from SPEP to IFE lab testing?
I just wanted to say thank you again for the SPEP / IgA testing information that all of you gave me. Just spoke with my oncologist about the testing. Apparently, he was holding off from the IFE test until my labs were down a little more although my last three lab sheets show a suggestion to use SPEP along with IFE.
My next lab orders show CBC, CMP, IgA, Serum Immunoelectrophoresis and SPEP. Now I just have to learn how to read these test results. Apparently the IFE will show what sub type of M-protein is present.
Castaway
My next lab orders show CBC, CMP, IgA, Serum Immunoelectrophoresis and SPEP. Now I just have to learn how to read these test results. Apparently the IFE will show what sub type of M-protein is present.
Castaway
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Have you been switched from SPEP to IFE lab testing?
Interesting post. At my doctor's visit today, I was told my doctor will request an IFE, as my M-spike isn't detectable on the SPEP. I will have to look back on my past blood tests to see if an IFE was ever requested. I think I will request an IFE to be part of my regular testing.
Thanks
Rhonda
Thanks
Rhonda
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Rhonda - Who do you know with myeloma?: myself
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 54
Re: Have you been switched from SPEP to IFE lab testing?
Just for another data point, I get the SPEP test performed monthly. If it gives a negative result every month for a year, they then perform an IFE for the extra sensitivity. (Not sure what the next step is when the IFE comes back negative as well.)
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Mike F - Name: Mike F
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: May 18, 2012
- Age at diagnosis: 53
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