Webexcess of an abnormal immunoglobulin called monoclonal protein (or M protein). So, the vast majority of people with MGUS dont go on to develop any disease. Drinking water will dilute your urine (water down the amount of protein and everything else in your urine), but will not stop the cause of your kidneys leaking protein. New York, NY 10065 No abstract available. The immunofixation tests showed no monoclonal proteins and the SPEP said this, Electrophoretic studies revealed that one or more fractions were outside the Mayo Clinic Staff. Some people may experience a rash or nerve problems, such as numbness or tingling. WebLow protein levels may be caused by many conditions. WebA Monoclonal Antibody is considered to specific to its intended target, if the Monoclonal Antibody has an S-score of at least 2.5. Finding M proteins in the blood or urine is usually a sign of disease. Its currently Learn about its causes, symptoms, treatment, and outlook. https://www.uptodate.com/contents/search. Merck Manual Professional Version. Its currently unknown how these diseases form, but they typically begin with one abnormal plasma cell in the bone marrow that multiplies. In blood cancers such as myeloma, the 'M' in 'M protein' stands for monoclonal. Please consider immunofixation analysis if indicated and not already ordered. Whats Causing My Preauricular Lymph Node to Swell? Does Social Distancing Impact the Immune System? The presence of M proteins in the body and a diagnosis of MGUS isnt necessarily a cause for concern. Know the reason for your visit and what you want to happen. Yet, with MGUS, the level of M proteins in the body is low and doesnt cause damage. The type of immunoglobulin this is varies from person to person. Beta1 globulin is high, beta2 and gamma are low. The Binding Site Group, Ltd; 06/2015; Optilite Freelite Lambda Free Kit. Diagnosis. Their presence is associated most commonly with a type of cancer of the plasma cells called multiple myeloma. (, Package inserts: Optilite Freelite Kappa Free Kit. Our website services, content, and products are for informational purposes only. The most common condition linked with these abnormal proteins is monoclonal gammopathy of undetermined significance (MGUS). Learn about its symptoms and treatment, Preauricular lymph nodes are in front of your ears and drain lymph fluid from your eyes, cheeks, and scalp near your temples. The Binding Site Group, Ltd; 06/2015, Clients without access to Test Prices can contact, Prospective clients should contact their account representative. Sebia, Inc; 12/2017), Immunofixation is performed with Sebia reagent sets and are specific for gamma, alpha, mu, kappa, and lambda immunoglobulin heavy and light chains. Data from the Mayo Clinic showed that the median survival of MGUS patients was 8.1 years compared to 11.8 in the comparable US population. A single copy of these materials may be reprinted for noncommercial personal use only. 2006;81(12):1575-1578, 4. 8th ed. WebQuantitative determination of the serum M component to demonstrate that an IgG or IgM monoclonal protein is less than 3.0 g/dL or an IgA monoclonal protein is less than 2.0 In most cases, Mayo Clinic doesn't require a physician referral. Accessed April 18, 2019. This usually includes regular physical exams and blood work. Mayo Clinic, Rochester, Minn. April 26, 2019. Social distancing is effective in helping to reduce the spread of disease, but it can also have negative impacts on emotional and mental health. Ill check into financial assistance but the hospital bill for my pancreatitis is $22,000 and they didnt mention any help. 425 East 61st St8th Floor gamma globulin region and, more rarely, in the beta or alpha-2 regions. Monoclonal gammopathies are conditions in which abnormal proteins are found in the blood. Protein is normally found in the blood. WebA patient with an IgG(chi) monoclonal serum protein developed in the course of the disease a second monoclonal spike of the same light chain type and of the IgA class. Include a high protein food with every meal. Infection, immune system problems, and the environment may play a role. Monoclonal gammopathy of undetermined significance (MGUS) (adult). -An absent alpha-1 fraction is consistent with A1AT deficiency disease and should be followed by a quantitative A1AT assay (AAT / Alpha-1-Antitrypsin, Serum). "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. I did this until I was able to get insurance and refused the big stuff until then. Method Name Only orderable as part of a profile. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Also know what the side effects are. Train The Trainer Cna Instructor Course In Alabama, Positive Displacement Pump Vs Centrifugal Pump. These diseases and conditions include: Chronic kidney disease Diabetic nephropathy (kidney disease) WebThe majority of sera (73.7%) demonstrating a restricted band of protein migration on SPE demonstrated abnormal IFE patterns suggestive of multiple myeloma or monoclonal gammopathy of unknown significance, but gave normal kappa/lambda FLC ratios using the turbidimetric immunoassays. Monoclonal gammopathy of undetermined significance is seen to be occurring when some atypical plasma cells make a protein called as M protein or paraprotein or monoclonal protein. Reference values have not been established for patients that are younger than 12 months of age. Create an account to follow your favorite communities and start taking part in conversations. Monoclonal gammopathy of undetermined significance (MGUS) care at Mayo Clinic Your Mayo Clinic care team Mayo Clinic's MGUS teams are led by hematologists and include other specialists as needed, such as nephrologists in cases of kidney failure and cardiology in cases of amyloid involving the heart. (Package insert: The quantitation of free light chain (FLC) by turbidimetry uses FLC antisera. In: Detrick BD, Hamilton RG, Schmitz JL, eds. You can learn more about how we ensure our content is accurate and current by reading our. Their main job is to fight off infection. -A monoclonal IgM of greater than 3 g/dL is consistent with macroglobulinemia. Their presence is associated most commonly with a type of cancer of the plasma cells called Very large IgG M-spikes (>4 g/dL) may saturate the protein stain. This means screening of siblings and children is not needed. WebMonoclonal means they are all of 1 kind. Reddit and its partners use cookies and similar technologies to provide you with a better experience. This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. TABLE 1. Also write down any new instructions your provider gives you. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications. Hypereosinophilic syndrome (HES) refers to a group of blood disorders caused by high levels of eosinophils. https://medical-dictionary.thefreedictionary.com/monoclonal+immunoglobulin. If myeloma is suspected as a result, your doctor tests your blood again to help Swollen lymph nodes in the groin could be due to various conditions, from sexually transmitted infections to athletes foot or even cancer. High-risk MGUS patients (M-spike >1.5, IgA or IgM, abnormal FLC ratio) have a lifetime risk of progression to MM of 60%. Direct bilirubin higher than total bilirubin? AskMayoExpert. Multiplying by the serum total protein converts the percentage of protein in each fraction into serum concentration. This makes them ineffective and even harmful. M-protein is an antibodyor part of an antibodythat can show up in tests of your blood and/or urine, and its presence can mean different things. People with monoclonal gammopathy generally don't experience signs or symptoms. Rajkumar SV, Kyle RA, Therneau TM, et al: Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance. The color change is due to abnormal protein or sugar, high levels of red and white blood cells, and high numbers of tube-shaped particles called cellular casts. Eliminating the need for urine monoclonal studies as a part of initial diagnostic studies (ie, rule-out monoclonal gammopathy), Assessing risk of progression from monoclonal gammopathy of undetermined significance to multiple myeloma. They may also notice unusual levels of protein in your urine. However, benign monoclonal proteins share several characteristics. If a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, an immunofixation electrophoresis specific for delta and epsilon chains is performed. Another test, called immunofixation or immunoelectrophoresis, is used to determine the exact type of abnormal antibody (IgG. About 1 percent of these people go on to develop multiple myeloma or a similar blood cancer. Also called M protein. WebTesting Algorithm. Imaging tests. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Sometimes, the plasma cells create abnormal proteins. Drinking water will not treat the cause of protein in your urine unless you are dehydrated. MGUS is usually detected by chance when you have a blood test for another condition. While a small amount is normal, a large amount of protein in urine may indicate kidney disease. Monoclonal gammopathy of undetermined significance (MGUS). A number of tests may be performed that lead to the identification of M proteins. PHP Pdf | Urine protein electrophoresis (UPEP) is. Blood. Phone: (646) 962-6500 If your doctor finds M proteins in your blood, they may run further tests to rule out any conditions related to MGUS that could cause problems. WebMonoclonal gammopathy of undetermined significance or MGUS (abnormal proteins in the blood; it can progress to cancer). Masks are required inside all of our care facilities. Mayo Clinic's MGUS teams are led by hematologists and include other specialists as needed, such as nephrologists in cases of kidney failure and cardiology in cases of amyloid involving the heart.. Having all of this WebOther monoclonal antibodies given to treat kidney diseases could also interfere with isoagglutinin. The exact cause of MGUS is not known. Thank you for that. Proteins are an important component of all living organisms. This subreddit is for the discussion of multiple myeloma, myeloma related news, resources, stories, and everything else associated with the disease. deficiency, hypoalbuminemia), the affected fraction is faint or absent. Ifx shows no monoclonal protein & free light chains are within normal range. The initial identification of an M-spike or an area of restricted migration is followed by immunofixation to identify the disorder if the clinical suspicion is high. These are A, G, M, D and E. Your type of myeloma is named after the abnormal immunoglobulin it is making. I keep reading and reading and reading and I dont know where I stand. Know how to contact your provider if you have questions. Know why a test or procedure is recommended and what the results could mean. A diagnosis of MGUS without any other symptoms usually does not call for more testing. This is often done with a lab test called electrophoresis. However, you shouldnt have a lot of protein in your urine. Mayo Clinic in Rochester, Minnesota, and Mayo Clinic in Phoenix/Scottsdale, Arizona, are ranked among the Best Hospitals for cancer by U.S. News & World Report. -In the hereditary deficiency of a protein (eg, agammaglobulinemia, alpha-1-antitrypsin [A1AT] deficiency, hypoalbuminemia), the affected fraction is faint or absent. Cytokine Release Syndrome: Symptoms, Causes, Treatments. Once a monoclonal gammopathy has been diagnosed, the size of the clonal abnormality can be monitored by PEL or FLC and, in some instances, by quantitative immunoglobulins. Learn how we can help Good luck. Plasma cell disorders. Mayo Clinic Staff. Choose leaner, slightly larger cuts of meat. Radiographic agents may produce an uninterpretable pattern. Most people who have abnormal proteins in their blood will never get worse. Normal value ranges may vary slightly among different laboratories. They can be swollen or, Though rare, severe combined immunodeficiency (SCID) is a serious disease causing weakened immune systems in children. MGUScauses no symptoms. Unclear question: Abnormal protein band 1 is not a commonly recognized diagnosis. Diagnosis of monoclonal gammopathy of undetermined significance. These abnormal antibodies can be found and measured in the blood and are referred to as paraprotein or m protein. This content does not have an English version. It involves placing a sample of the liquid part of your blood (called serum) into a gel thats exposed to an electric current. Afterwards, your doctor may During gluconeogenesis in the liver pyruvate is converted to phosphoenolpyruvate? -Low-risk MGUS patients are defined as having an M-spike of less than 1.5 g/dL, IgG monoclonal protein, and a normal FLC K/L ratio (0.25-1.65), and these patients have a lifetime risk of progression to MM of less than 5%. 2005-2023 Healthline Media a Red Ventures Company. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2019. WebImmunoglobulins can be classified into one of 5 types depending on their heavy chains. Monoclonal proteins are markers of plasma cell proliferative disorders. Purpose. A homogeneous immunoglobulin resulting from the proliferation of a single clone of plasma cells that; during electrophoresis of serum, appears as a narrow band or "spike"; it is characterized by heavy chains of a single class and subclass, and light chains of a single type. They can be found in all types of body tissues, including the blood. Which is true about monoclonal antibodies? This test uses an electric current to push proteins in a urine sample through a special gel. -Patients suspected of having a monoclonal gammopathy may have normal serum PEL patterns. Undetected antigen excess is a rare event but cannot be excluded. Long-term damage to your kidneys may be corrected by restricting protein, if you are diabetic, or experiencing kidney problems. Solitary plasmacytoma (early-stage plasma cell cancer). The most common condition linked with these abnormal proteins is monoclonal gammopathy of undetermined significance (MGUS). It is not cancer. But people with MGUS have a greater risk of getting serious diseases of the bone marrow and blood. What causes monoclonal gammopathies? The exact cause of MGUS is not known. Your bone marrow is a soft tissue found inside most of your bones that produces blood cells. Thank you. Its confusing though. Because MGUS usually causes no symptoms, it's usually detected by chance during blood tests for other conditions. Manual of Molecular and Clinical Laboratory Immunology. Results should always be interpreted in conjunction with other laboratory tests and clinical evidence; any anomalies should be discussed with the testing laboratory. -A characteristic monoclonal band (M-spike) is often found on protein electrophoresis (PEL) in the. Most cases of multiple myeloma start out as a usually harmless condition called monoclonal gammopathy of undetermined significance (MGUS). Fax: (212) 746-8961, Toggle Research and Clinical Trials menu options, About Multiple Myeloma, Amyloidosis, and Other Plasma Cell Disorders, Risk Factors for Multiple Myeloma and Other Plasma Cell Disorders, Diagnosing Multiple Myeloma and Other Plasma Cell Disorders, Multiple Myeloma and Plasma Cell Disorder Treatment. -A characteristic monoclonal band (M-spike) is often found on protein electrophoresis (PEL) in the gamma globulin region and, more rarely, in the beta or alpha-2 regions. High blood protein. Undetected antigen excess is a rare event but cannot be excluded. If a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, an immunofixation electrophoresis specific for delta and epsilon chains is performed. WebTesting Algorithm. Factors that increase your risk of developing MGUS include: Each year about 1% of people with MGUS go on to develop certain types of blood cancers or other serious diseases such as: Other complications associated with MGUS include bone fractures, blood clots and kidney problems. Approximately 8% of MM patients have hypogammaglobulinemia without a quantifiable M-spike on PEL but identified by IFE and/or FLC. Higher levels of M protein in the blood can lead to complications. If the free light chain results do not agree with other clinical or laboratory findings, or if the sample is from a patient that has previously demonstrated antigen excess, the result must be checked by retesting at a higher sample dilution. WebIf a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, immunofixation electrophoresis specific for delta and epsilon chains is performed, if not previously performed, or at the discretion of the laboratory director reviewing the case. In: Detrick BD, Hamilton RG, Schmitz JL, eds. These proteins show up in the urine in many people with multiple myeloma. Accessed April 18, 2019. In. Antibodies are produced naturally by your body and help the immune system recognize germs that This abnormal protein is formed within your bone marrow, the soft, blood-producing tissue that fills in the center of most of your bones. Multiple Myeloma (also known as myeloma) is cancer of the plasma cells in the bone marrow. A gammopathy is an abnormal increase in the bodys ability to produce antibodies. Other blood and urine tests can tell you more, a biopsy and imaging scans even more. Other common names for these proteins include: Finding M proteins in the blood or urine is usually a sign of disease. WebA Monoclonal Antibody is considered to specific to its intended target, if the Monoclonal Antibody has an S-score of at least 2.5. If a monoclonal light chain is detected in the absence of an associated monoclonal heavy chain, an immunofixation electrophoresis specific for delta and epsilon chains is performed. But because MGUS may lead to a more serious condition, youll need checkups throughout your life. structure and function of flowering plants ppt. It says poorly but A faint IgG kappa monoclonal immunoglobulin is detected. 2019 MINI COOPER S COUNTRYMAN SIGNATURE in Edmond, OK Mini Cooper Countryman Features and Specs. Swollen Lymph Nodes in the Groin: What Does It Mean? All rights reserved. The initial identification of an IgM, IgA, or IgG M-spike greater than 4 g/dL, greater than 5 g/dL, and greater than 6 g/dL, respectively, should be followed by VISCS / Viscosity, Serum. This will help find problems as early as possible. Amyloidosis is a condition in which too much of a particular protein (amyloid) collects in the organs, so that they are not able to work normally. Experts do know that the abnormal proteins are not caused by a certain diet or from eating dietary proteins. A single copy of these materials may be reprinted for noncommercial personal use only. Antigenic analysis of the To find these identical M proteins, your doctor might run a blood test called serum protein electrophoresis (SPEP). Today, a multiple myeloma diagnosis is no longer a death sentence because our community's efforts have helped bring 11 new drugs through FDA-approval. What does the following interpretation mean? This is called electrophoresis. The study (ClinicalTrials.gov, NCT04346914) is an open label, single-arm phase Ib clinical trial investigating the safety, tolerability, and efficacy of the recombinant human anti-programmed death-ligand 1 (PD-L1) monoclonal antibody Socazolimab in combination with carboplatin and etoposide in the first-line treatment of Monoclonal gammopathy of undetermined significance (MGUS). Monoclonal and Polyclonal Immunoglobulin Interference in a Conjugated Bilirubin Assay, monoclonal gammopathy of unclear significance, monoclonal gammopathy of undetermined significance, monoclonal gammopathy of unknown significance, Monoclonal Gammopathies of Unknown Significance, Monoclonal Gammopathy of Borderline Significance, Monoclonal Gammopathy of Renal Significance, Monoclonal Gammopathy of Uncertain Significance, Monoclonal gammopathy of undetermined significance, Monoclonal gammopathy of unknown significance, Monoclonal Immunoglobulin Deposition Disease, Monoclonal Light-Chain-Related Renal Disease, Monoclonal Lymphocytosis of Undetermined Significance, Monoclonal Lymphoproliferative Disorders of Undetermined Significance, Monoclonal Rheumatoid Factor Solid Phase Assay. The most common condition linked with these abnormal proteins is MGUS. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. WebOther monoclonal antibodies given to treat kidney diseases could also interfere with isoagglutinin. Accessed April 18, 2019. n follow-up PEL can be used to monitor the monoclonal gammopathy. An absent alpha-1 fraction is consistent with A1AT deficiency disease and should be followed by a quantitative A1AT assay (AAT / Alpha-1-Antitrypsin, Serum). The most common condition linked with these abnormal proteins is MGUS. While the identification of the monoclonal gammopathy is a laboratory diagnosis, the specific clinical diagnosis is dependent on a number of other laboratory and clinical assessments. WebMGUS (monoclonal gammopathy of undetermined significance). The information shared above about the question, TOP 10 what does no monoclonal protein detected mean BEST and NEWEST, TOP 10 what does no me queda mas mean BEST and NEWEST, TOP 9 what does no less than mean BEST and NEWEST, TOP 10 what does no host bar mean BEST and NEWEST, TOP 10 what does no harm no foul mean BEST and NEWEST, TOP 10 what does no greek mean sexually BEST and NEWEST, TOP 9 what does no contest mean in ufc BEST and NEWEST, TOP 9 what does no classic mean at starbucks BEST and NEWEST. The images can help your doctor find bone abnormalities related Too much caffeine being consumed on a daily basis. High blood protein is not a specific disease or condition in itself, but it might indicate you have a disease. WebWhat does no monoclonal protein mean? If a monoclonal protein pattern is detected by IFE or FLC, a diagnosis of a monoclonal gammopathy is established. Monoclonal gammopathies may be present in a wide spectrum of diseases that include malignancies of plasma cells or B lymphocytes (multiple myeloma [MM], macroglobulinemia, plasmacytoma, B-cell lymphoma), disorders of monoclonal protein structure (primary amyloid, light-chain deposition disease, cryoglobulinemia), and apparently benign, premalignant conditions (monoclonal gammopathy of undetermined significance [MGUS], smoldering MM). Before your visit, write down questions you want answered. This site complies with the HONcode standard for trustworthy health information: verify here. Abnormal Reports, SI Normal Reports | -Patients suspected of having a monoclonal gammopathy may have normal serum PEL patterns. Some people are more at risk than others. High blood protein rarely causes signs or symptoms on its own. A 24-hour urine collection can help determine if abnormal protein is being released into your urine. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Weill Cornell Medicine Myeloma Center A mono (one)clonal population of ig's is mgus -- monoclonal gammopathy of undetermined significance -- or related to a more significant problem. lin a homogeneous immunoglobulin resulting from the proliferation of a single clone of plasma cells; during electrophoresis of serum, it appears Besides multiple myeloma, presence of M proteins in your blood may result in: Most people are diagnosed with MGUS during blood tests for other conditions that affect the bloods protein levels, such as a nerve disorder called peripheral neuropathy. Once this abnormal cell forms, it begins to multiply rapidly and does not die as a normal cell does. For more information on visiting Mayo Clinic, choose your location below: Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. The finding of an M-spike, restricted migration, or hypogammaglobulinemic PEL pattern is suggestive of a possible monoclonal protein. -The initial identification of an IgM, IgA, or IgG M-spike greater than 4 g/dL, greater than 5 g/dL, and greater than 6 g/dL, respectively, should be followed by VISCS / Viscosity, Serum. The more M proteins in your blood and the longer youve had MGUS, the higher your risk of developing one or more related conditions. If the result of a total protein test is abnormal, further tests will be needed to identify which proteins are too high or too low. These protective proteins attack and kill off invading disease(s). Bence-Jones proteins are 1 type. FLC = high lambda at 33.4mg/l If you are experiencing bone pain, your doctor might recommend an MRI or ositron emission tomography (PET) scan. If you have high amounts of this protein in your blood, it's important to have regular checkups so that you can get earlier treatment if it does progress. these situations, quantitative IgG assays more accurately determine M-spike concentrations for monitoring disease progression or response to therapy. All Rights Reserved. These abnormal proteins are called M proteins, or monoclonal proteins. In the United States, MGUS affects about 3 percent of people above age 50. This test separates proteins based on their size and other factors. So when the Serum Protein Electrophoresis (SPEP) test shows a spike in M protein, this is a sign of MM. Mayo Clinic Staff. Accordingly, a normal serum PEL does not rule out the disease and PEL alone should not be used to screen for the disorder if the clinical suspicion is high. Monoclonal gammopathy of undetermined significance (MGUS) care at Mayo Clinic. When plasma cells become cancerous, they make abnormal antibodies in large quantities that serve no useful function. This test can be used to diagnose a kidney condition or see if a treatment is working. Thank you. No monoclonal protein in IFE time is required before collecting blood for protein EP by CE after a patient receives iodinated contrast media. The chance of getting MGUS grows with age, but it is not common. Talk to the doctor about the fewest tests they can do and get a quote upfront. A serum monoclonal protein (SMP) is a protein that is specific to a single cell, or cell population. It is used in lab research to track the progress of a disease or to study the effects of treatments. Amyloidosis can affect the heart, kidneys, liver, spleen, nervous system, stomach or intestines. A doctor may notice abnormal proteins and odd levels of normal proteins during such a test. Serum proteins are separated in an electric field according to their size, shape, and electric charge. A monoclonal IgG or IgA of greater than 3 g/dL is consistent with multiple myeloma (MM). -A depressed gamma fraction (hypogammaglobulinemia) is consistent with immune deficiency and can also be associated with primary amyloidosis or nephrotic syndrome. Frequent infections that are hard to treat. This has to be examined carefully. In multiple myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. With the addition of the serum free light-chain (FLC) assay, the expanded monoclonal protein study provides even more diagnostic sensitivity for the monoclonal light-chain diseases such as primary amyloid and light-chain deposition disease; disorders that often do not have serum monoclonal proteins in high enough concentration to be detected and quantitated by PEL. Protein Electrophoreses are within range, Hi Dr. David,This is the guy who was consulting with you previously about monoclonal diseases like myeloma and amyloidosis. CMS Pdf, Normal Reports | In addition, if the patient is asymptomatic and has a diagnosis of MGUS, the expanded monoclonal protein study panel provides the information (size of M-spike, monoclonal protein isotype, FLC K/L ratio) needed for a MGUS progression risk assessment (see Interpretation). Let's look at symptoms and, Cytokine release syndrome is an immune system response that can occur due to immunotherapy or infection. Mayo Clinic in Jacksonville, Florida, is ranked highly performing for cancer by U.S. News & World Report. More than 20,000 new patients will be diagnosed this year. Accessed April 18, 2019. A monoclonal IgM of greater than 3 g/dL is consistent with macroglobulinemia. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. In these situations, quantitative IgG assays more accurately determine M-spike concentrations for monitoring disease progression or response to therapy. Manual of Molecular and Clinical Laboratory Immunology.