Hi,
I have never posted here in the forum before, but I have enjoyed The Myeloma Beacon for quite sometime. I really appreciate everyone's questions and I have learned so much from the informative and knowledgeable responses. However, I have a lot to learn and I am still confused most of the time. LOL. Its so frustrating! So I hope someone can help clarify a question for me.
Blair77 wrote: " I'm wondering what monitoring Immunoglobulin levels adds to the analysis if IFE, light chains, and SPEP are already being run once a month to monitor for relapse? "
My question is, isn't the IFE an immunofixation ? And doesn't that already measure and quantify all the individual immunoglobulin levels? Why would another test measuring the Immunoglobulin levels be needed? And how would the test be able to determine the healthy immunoglobulins vs. the monoclonal immunoglobulin's? I thought that was what the SPEP (serum protein electrophoresis) was used for with the measure of the M-Spike.
Obviously I'm confused once again, and I'm really sorry if I missed something. I would truly appreciate any help given! Thank you!
Forums
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djudd - Name: djudd
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: MGUS 2003, SSM 2012
- Age at diagnosis: 36
Re: What's the added value of immunoglobulin results?
Hi djudd,
The SPEP tells you how high your M-spike. It doesn't tell you, however, whether your M-spike is IgG, IgA, IgM, IgD, or IgE.
That's what your immunofixation electrophoresis (IFE) tells you. In fact, it's just about all that the IFE tells you. The IFE does't tell you how big the M-spike is, or what your other immunoglobulin levels are. It just tells you the type of M-spike you have.
The immunoglobulins test tells you your total IgG, IgA, and IgM levels. Those totals include both the normal, functioning immunoglobulins and the monoclonal, non-functioning (myeloma-related) immunoglobulins.
So, say you have IgG type myeloma and you're newly diagnosed, or you've been treated but have not achieved a complete response. Then the total IgG level reported in your immunoglobulins lab results includes both the normal IgG molecules and myeloma-related IgG molecules.
To figure out what the level of the normal IgG molecules are, you need to do a calculation like Multibilly did earlier in these postings,
https://myelomabeacon.org/forum/value-of-immunoglobulin-test-results-t3600.html#p20583
So, again as an example, if you have IgG-type myeloma, your M-spike is 0.5 g/dL (500 mg/dL), and your total IgG level was reported as 1610 mg/dL, then the level of your normal IgG is calculated this way:
Normal IgG = Total IgG - M-spike = 1610 mg/dL - 500 mg/dL = 1100 mg/dL
That means your level of normal (functioning) IgG is in the middle of the reference range for (normal) IgG, which is 700 - 1500 mg/dL. As Multibilly mentioned, that's good to know, since it means you have a normal amount of IgG for your body to use to fight infections.
I hope this clears things up a bit. If you still have questions, just post them here, and I'll see if I can answer them. (I'm not making any promises, but I'll try!)
The SPEP tells you how high your M-spike. It doesn't tell you, however, whether your M-spike is IgG, IgA, IgM, IgD, or IgE.
That's what your immunofixation electrophoresis (IFE) tells you. In fact, it's just about all that the IFE tells you. The IFE does't tell you how big the M-spike is, or what your other immunoglobulin levels are. It just tells you the type of M-spike you have.
The immunoglobulins test tells you your total IgG, IgA, and IgM levels. Those totals include both the normal, functioning immunoglobulins and the monoclonal, non-functioning (myeloma-related) immunoglobulins.
So, say you have IgG type myeloma and you're newly diagnosed, or you've been treated but have not achieved a complete response. Then the total IgG level reported in your immunoglobulins lab results includes both the normal IgG molecules and myeloma-related IgG molecules.
To figure out what the level of the normal IgG molecules are, you need to do a calculation like Multibilly did earlier in these postings,
https://myelomabeacon.org/forum/value-of-immunoglobulin-test-results-t3600.html#p20583
So, again as an example, if you have IgG-type myeloma, your M-spike is 0.5 g/dL (500 mg/dL), and your total IgG level was reported as 1610 mg/dL, then the level of your normal IgG is calculated this way:
Normal IgG = Total IgG - M-spike = 1610 mg/dL - 500 mg/dL = 1100 mg/dL
That means your level of normal (functioning) IgG is in the middle of the reference range for (normal) IgG, which is 700 - 1500 mg/dL. As Multibilly mentioned, that's good to know, since it means you have a normal amount of IgG for your body to use to fight infections.
I hope this clears things up a bit. If you still have questions, just post them here, and I'll see if I can answer them. (I'm not making any promises, but I'll try!)
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Jonah
Re: What's the added value of immunoglobulin results?
How do you figure out IgA. Can you give me an example? Thank you.
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Mon
Re: What's the added value of immunoglobulin results?
Mon,
If you have IgA myeloma, then the principle is the same as Jonah explained for IgG myeloma. You would calculate the level of your normal IgA as follows:
Normal IgA = Total IgA - M-spike
However, the normal range for IgA is different than it is for IgG. For IgA, the normal range is about 60 - 400 mg/dL.
The other important thing to point out is that measuring M-spikes in the case of IgA myeloma is less reliable than it is for IgG myeloma. So measuring your "Normal IgA" using the formula above will also be less reliable and may sometimes lead to strange results such as negative levels of normal IgA. For more information, see these forum discussions and postings
"IgA immunoglobulin vs. M-spike", Beacon forum discussion started Jan 25, 2011; includes postings from Dr. Craig Hofmeister and Dr. Peter Voorhees.
"Re: Elevated IgA level - sign of relapse?", forum posting by wesley on Sep 4, 2014.
If you have IgA myeloma, then the principle is the same as Jonah explained for IgG myeloma. You would calculate the level of your normal IgA as follows:
Normal IgA = Total IgA - M-spike
However, the normal range for IgA is different than it is for IgG. For IgA, the normal range is about 60 - 400 mg/dL.
The other important thing to point out is that measuring M-spikes in the case of IgA myeloma is less reliable than it is for IgG myeloma. So measuring your "Normal IgA" using the formula above will also be less reliable and may sometimes lead to strange results such as negative levels of normal IgA. For more information, see these forum discussions and postings
"IgA immunoglobulin vs. M-spike", Beacon forum discussion started Jan 25, 2011; includes postings from Dr. Craig Hofmeister and Dr. Peter Voorhees.
"Re: Elevated IgA level - sign of relapse?", forum posting by wesley on Sep 4, 2014.
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