Hello,
A friend of mine has smoldering myeloma for a number of years and would like to know what is considered a really high M-spike. For example, his IgG is 3500, and no one seems concerned, but he is.
Is there a certain M-spike or IgG level that is considered worrisome, or the basis for treatment, even if there are no "CRAB" symptoms? Are there any relevant guidelines?
Kate
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Re: What is a high M-spike for smoldering myeloma?
Hi Kate,
While a total IgG level and an IgG M-spike level are related, they don't necessarily track.
In a patient with IgG-type smoldering myeloma, the total IgG level is made up of the M-spike + the normal (healthy) IgG level. A normal IgG level lies somewhere between 700-1600 mg/dL. Without knowing his M-spike level, I would guess that with a total IgG level of 3500 mg/dL that his M-spike level is somewhere around 2500 - 2800 mg/dL (or 2.5 - 2.8 g/dL). For a smoldering myeloma patient, this is not that high of an M-spike.
In fact, in order to be diagnosed with smoldering myeloma based solely on one's M-spike level, you would need to have an M-spike greater than 3 g/dL. So, he either has an M-spike level that is just over 3 g/dL or he has a bone marrow plasma cell percentage reading that is over 10%. But again, these are not high M-spike levels for a smoldering patient.
You might want to read this article to be more aware of what specific things to be concerned about when it comes to whether treatment might be necessary in the future:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
While a total IgG level and an IgG M-spike level are related, they don't necessarily track.
In a patient with IgG-type smoldering myeloma, the total IgG level is made up of the M-spike + the normal (healthy) IgG level. A normal IgG level lies somewhere between 700-1600 mg/dL. Without knowing his M-spike level, I would guess that with a total IgG level of 3500 mg/dL that his M-spike level is somewhere around 2500 - 2800 mg/dL (or 2.5 - 2.8 g/dL). For a smoldering myeloma patient, this is not that high of an M-spike.
In fact, in order to be diagnosed with smoldering myeloma based solely on one's M-spike level, you would need to have an M-spike greater than 3 g/dL. So, he either has an M-spike level that is just over 3 g/dL or he has a bone marrow plasma cell percentage reading that is over 10%. But again, these are not high M-spike levels for a smoldering patient.
You might want to read this article to be more aware of what specific things to be concerned about when it comes to whether treatment might be necessary in the future:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What is a high M-spike for smoldering myeloma?
Hi Mulitbilly,
Thank you for the link. Meanwhile, I also found this link and printed it for him.
SV Rajkumar, O Landgren, M-V Mateos, "Smoldering multiple myeloma," Blood, May 14, 2015 (full text in HTML format, full text as PDF)
Kate
Thank you for the link. Meanwhile, I also found this link and printed it for him.
SV Rajkumar, O Landgren, M-V Mateos, "Smoldering multiple myeloma," Blood, May 14, 2015 (full text in HTML format, full text as PDF)
Kate
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Kate - Name: Kate
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Dec. 2012
Re: What is a high M-spike for smoldering myeloma?
Hi Kate,
Multibilly also may remember this, but the article you mentioned is the subject of this forum thread:
"Review article - smoldering multiple myeloma" (started May 27, 2015)
We mention the earlier discussion in case there's anything in it that might be of interest to you or your friend.
Also, there are some additional postings in this thread,
"What is a high M-spike?" (started April 10, 2015)
that deal with the question of what M-spike level is "high."
Multibilly also may remember this, but the article you mentioned is the subject of this forum thread:
"Review article - smoldering multiple myeloma" (started May 27, 2015)
We mention the earlier discussion in case there's anything in it that might be of interest to you or your friend.
Also, there are some additional postings in this thread,
"What is a high M-spike?" (started April 10, 2015)
that deal with the question of what M-spike level is "high."
4 posts
• Page 1 of 1