Monitoring Monoclonal Gammopathies

Large IgG kappa M-spike

November 2009

Now compare this to patients with large M-spikes. They often have suppression of the polyclonal immunoglobulins. In this patient, the nephelometric IgG serves as a good measurement for the clonal plasma cells. Many clinicians order both the serum PEL as well as serum IgG quantitation, and both methods should be changing in the same direction. They are not, however, equivalent and this sometimes leads to confusion.

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Jump to section:

• Introduction
• Slide Images
• International Myeloma Working Group: Disease Monitoring
• Serum Protein Electrophoresis and Immunofixation Electrophoresis
• Serum and Urine Protein Electrophoresis and Immunofixation Electrophoresis
• Methods for Monitoring Monoclonal Gammopathies: 2005 IMWG
• Methods for Monitoring Monoclonal Gammopathies
• Small IgG kappa M-spike
• Large IgG kappa M-spike
• Relationship of Serum Agarose Electrophoresis M-spike and Ig Quantitation¹
• Disease Monitoring
• Monoclonal Gammopathies: Primary Systemic Amyloidosis
• Free Light Chain: Antibody Specificity
• FLC κ/λ Ratio: Disease Sensitivity²
• Methods for Monitoring Monoclonal Gammopathies
• International Myeloma Working Group: 2009 Guidelines for Disease Monitoring³
• Response Criteria for FLC^4,5
• Receiver Operator Curve (ROC): % FLC Reduction vs. Overall Hematologic Response⁶
• International Myeloma Working Group: 2009 Guidelines for Disease Monitoring
• References
• Questions?