[AliceNorth]

Trace reading of myeloma on IFE - sign of relapse?

by AliceNorth on Tue Sep 16, 2014 4:36 pm

Hi everyone,

I've posted previously and earlier, so apologies if you've read this already ...

Briefly, I have IgA lambda myeloma and amyloidosis. After frontline treatment of CTD (cyclo­phos­pha­mide, thalidomide, and dex), I was in complete response and had been for just over 3 years.

8 weeks ago, my blood was showing a reappearance of IgA lambda on immunofixation, i.e. a trace reading. All other bloods, including light chains and IgA level, were normal. Consultant thought it could be a transient reading and planned to retest 8 weeks later.

So, 8 weeks on, and the result is exactly the same - a trace reading of IgA lambda on IFE, normal light chains, and normal IgA level (1.4 g/l - normal range 0.8-4.0).

My question is, has anyone else had this experience?

To be honest, I thought it would either disappear, or progress. Is it possible that this could still be a transient reading and disappear, or is it more likely that this is a slow relapse?

Alice

[Dr. James Hoffman]

Re: Trace reading of myeloma on IFE - sign of relapse?

by Dr. James Hoffman on Tue Sep 16, 2014 8:35 pm

It seems most likely that your myeloma clone is marginally detectable at this point. To know whether this represents 'slow progression,' as you mention, or simply stable, low volume disease, will take time.

It could disappear, as there can be some waffling of the numbers in myeloma, but I wouldn't think about it in such concrete terms. Unfortunately, the myeloma clone is always present, even in remission, as the nature of the disease is to relapse. The idea of 'cure' is a goal within the research community, but is not currently attainable for the vast majority of myeloma patients with conventional therapy.

The good news is that your disease seems to be barely identifiable at present and not really quantifiable. This could last for quite a while. Only further follow up will clarify.

Hope this helps, and I hope things stay quiet for a long time.

[AliceNorth]

Re: Trace reading of myeloma on IFE - sign of relapse?

by AliceNorth on Wed Sep 17, 2014 4:57 am

Thank you so much, Dr. James, for the clear explanation. This really helps. Fingers crossed it stays like this for a while!

Alice

[AliceNorth]

Re: Trace reading of myeloma on IFE - sign of relapse?

by AliceNorth on Wed Oct 01, 2014 8:15 am

Hi

Further to the above, nothing has essentially changed except that I have received my confirmation letter from my local hospital following my haematology appointment a few weeks ago. My local hospital carries out their own tests in addition to the tests carried out by the hospital that monitors my amyloidosis. Both blood samples were taken at the same time by my local hospital, but one sample is posted to the amyloidosis hospital.

The amyloidosis hospital showed a trace IgA lambda paraprotein on immunofixation. When I saw my local haematologist the day after I received this result, he had only the total protein and individual Ig numbers (all normal) from their tests, The letter I have now received from my local hospital states "protein electropheresis has normal pattern".

Would I be right to assume that my local hospital did not carry out immunofixation, which is a more sensitive test and hence has not revealed any paraprotein, or is it possible that there are differences in lab equipment producing differing results?

I am waiting for my local hospital to come back on this, but, in the meantime, wondered what you guys thought as I'm a bit confused now

Alice