Does IGG level of 120 and presence of monoclonal kappa light chain protein indicate myeloma

Hi, Not all patients with monoclonal light chains have myeloma. Let me answer your question in some detail. Myeloma is actually a spectrum of related diseases of different severities and outcomes. It is important to understand the different entities and their definitions, because the different entities may have completely varied implications on treatment and prognosis. The diagnosis of multiple myeloma is made when certain criteria are met. These criteria have been modified from time to time, and currently the most accepted criteria have been formulated by the International Myeloma Working Group. (Reference: British Journal of Hematology, May 2003, corresponding author: Dr Robert Kyle, Mayo Clinic, Rochester, USA). I will describe the different entities for you, and mention the criteria used for defining each of them. Myeloma cells secrete a protein called "M protein", which is IgG in 70% of cases, and IgA in 20%. 1. Monoclonal Gammopathy of Undetermined Significance (MGUS): monoclonal protein < 30 g/l and bone marrow clonal cells < 10% 2. Asymptomatic or smouldering myeloma: M-protein is ≥ 30 g/l and/or bone marrow clonal cells ≥ 10% but no organ damage or symptoms 3. Symptomatic myeloma: M-protein is ≥ 30 g/l and/or bone marrow clonal cells ≥ 10%, with organ damage or symptoms. These symptoms include increased calcium, renal insufficiency, anaemia, or bone lesions. You should also be aware of an entity called "Non secretory myeloma" where myeloma is present but does not secrete M protein. Other entities like plasmacytoma have also been defined. Other classic defining criteria of multiple myeloma have used levels of Immunoglobins as follows: IgG > 3.5 g/dl or IgA > 2 g/dl. You have asked: "I know that myeloma patients have monoclonal light chains, but does a patient with monoclonal light chains necessarily have myeloma?". I hope the above definitions have helped clarify that point. I hope my answer was not too complex. Please feel free to ask any follow-up questions. All the best, and God bless.

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