[nadia33]

Immunoglobulin questions

by nadia33 on Thu Jun 23, 2011 11:00 pm

Before the start of vel, rev , and dex... IgA and igM were borderline low and IgG was in normal range. After one cycle of the medications, IgG has dropped way below a normal range. Is this something that is normal and a good result? Should the patient be warned about immuno suppression and the preventive actions in order to avoid infections?
This patient has also been diagnosed with IgG kappa monoclonial protein even though IgG was in normal range. Any information on this ? Thank u.

[Dr. Edward Libby]

Re: Immunoglobulin questions

by Dr. Edward Libby on Fri Jun 24, 2011 1:04 am

In general, the level of immunosuppresion is not severe with treatment for myeloma. Myeloma itself causes immunosuppression. The fall in IgG is probably due to a fall in the malignant protein (or m-spike) from a reduction in the level of myeloma cells. One can have normal levels of serum immunoglobulins and still have myeloma. This finding does not have any prognostic significance.

[Perseverence]

Re: Immunoglobulin questions

by Perseverence on Fri Jun 24, 2011 2:27 pm

CyBordD + SCT + Rev maint. acheived a molecular complete response w/ normalization of FLC ratio.

IGA kappa was 3900 at DX last year. IGA number dropped rapidly and dramatically after CyBorD and has remained in the teens and is now 10. IGG and IGM also are persistently low. While there is no disease present, should it be a concern that all three antibody numbers remain below the normal range?

Sidebar: I am giving the IG numbers as absolutes as opposed to the g/l conversion I often see.

*Note from the Beacon Staff: This post was moved here as Dr. Libby's response above may be helpful in answering this question.

[Dr. Edward Libby]

Re: Immunoglobulin questions

by Dr. Edward Libby on Sat Jun 25, 2011 10:39 am

Perseverence,
I would not have concern that your immunoglobulin levels are low. The exception to this would be if you develop severe recurring bacterial infections (unlikely).