[HRSLVR23]

Two Monoclonal Proteins on SEP

by HRSLVR23 on Sat Feb 02, 2013 11:40 am

Hello, my name is Denise and I was diagnosed Jan 2010.

I received RVD as induction, collected for stem cell transplant but decided to wait. I am still doing fine and am enjoying life and staying active.

I have a friend with multiple myeloma and she showed me her latest SEP results that showed two monoclonal test results. One measured .23 and the second .34. This is so confusing to me because I thought we could only have one monoclonal protein to deal with, IGG IGA IGD IGE IGM.

I have not been to my doctor to clue me in on this puzzle.
Any thoughts from you?

I am IGG Kappa with chronic kidney disease.

[Ricardo]

Re: Two Monoclonal Proteins on SEP

by Ricardo on Sun Feb 03, 2013 11:26 am

Hi Denise,

I believe the kind of situation your friend is in is discussed in this recent article:

https://myelomabeacon.org/news/2013/01/16/different-m-spike-after-stem-cell-transplantation-linked-to-improved-survival-ash-2012/

The article says that it's possible to have two different m-spikes even at diagnosis. Also, it's possible after a transplant to develop a completely different kind of m-spike, and in some cases even develop two m-spikes.

R

[Multibilly]

Re: Two Monoclonal Proteins on SEP

by Multibilly on Mon Feb 04, 2013 8:03 pm

Without really seeing how your lab test reads exactly, please note the following, which may explain what you are seeing (at least I believe that having more than one abnormal cell line would produce more than one M-Spike type). I caution you that I am a total novice at interpreting these reports.

...In contrast to the great diversity of normal immunoglobulins, in monoclonal gammopathies a single abnormal cell line predominates (or in the rare case two or three). The abnormal cell(s) may produce an intact immunoglobulin, free light chains without heavy chains (often both intact and free), and rarely only heavy chains.

The above is from:

http://www.clinchem.org/content/46/8/1230.full

What do the various IgG, IgA, etc quantities show (usually expressed in mg/dL) on the lab report? Do they show two different immunoglobulins that are high? What about the free light chain quantities?

[HRSLVR23]

Re: Two Monoclonal Proteins on SEP

by HRSLVR23 on Tue Feb 05, 2013 9:09 pm

Thank you both so much for your reply to my question regarding the two M spikes in question. My friend Judy from my support group shared her SEP test, but not any other tests. I thought that two m spikes would be impossible, so glad I didn't say anything! Lost several nights of sleep trying to find information on the web. So now that I have links from you I am researching again!

Love the mountain scene! My husband and I are off to Yellowstone next week for some snowmobiling.