Third Visit With Dana Farber

Well on December 17th I had a visit with Dana Farber. I have to say it was interesting. This was my first "true" visit after vaccination so I was interested to see the results.  They were... as follows:

1. CBC: Completely normal.  My WBC came back up to the normal range.  My RBC was down slightly but I do think that was due to blood donation in October. 
2. CMP: Completely normal. My liver enzymes were under twenty and my Alkaline Phosphate was down to 60.
3. Immunoglobulins: IGM: 272, IGA: 180, IGG: 830. My Igm and Igg were off, but are mostly still normal.  This one is hard to judge because I had tests just a month before and my IGM was 240. 
4. Light Chain: Kappa 15.5 mg/L(normal),  Lambda: 9.1 mg/L (normal) - Ratio: 1.70 (almost normal).
5. M-spike: 0.23 g/dl (gamma).

I remain confused. Since my diagnosis my M-spike has been coming back with two spikes. Both IGM-Kappa. Thus I thought I was bi-clonal and that I had a M-spike with both values... around .5 g/dl.  I always asked about it but didn't get an answer... just "I am not worried about it" from the doctor.  So this time I asked the doctor, why, sometimes did the second spike go away. I was shocked for her to tell me that I was NOT biclonal... and that I didn't have a second spike. 

On my very first Pathology Report from Dana Farber it did some back with a second M-spike but it said this...

The findings are consistent with monomeric and pentameric forms of IgM paraprotein, and do not necessarily indicate biclonality.

My doctor says that the second spike is just a mirror image of the first, "true" spike.  She says that monomeric IGM paraprotien looks like a "Y" - while pentameric looks like a "snowflake" - upside down Ys. So when the monomeric gets all squished together in the gel... it can appear to have a second spike but it is not real. From the start this second spike is always reported as "faint" so it does make sense that it could be a reflection.  I will continue to research this... because I am not 100% sure I do understand but since my second path result has now come back without it.. it seems I may have a much smaller spike than I thought. 

In addition, I am coming up on my two year anniversary of my MGUS discovery. And, knock on wood, I have not really progressed anything but slightly. So small I can't even tell if I have progressed. I think that is a good sign.  I thought I heard someplace that if you don't progress after 5 years you probably won't ever. I hope that is the case. The doctor and I decided to push the appointments back to every 6 months.