Following three years of disease-free status, a patient presented with a recurrent monoclonal IgGK immunoglobulin during a routine follow-up evaluation (PEL 1). Therapy was reinstated and consisted of daratumumab, lenalidomide, and dexamethasone. Despite clinical improvement, two detectable monoclonal proteins of IgGΚ isotype were found on follow-up a month later (PEL 2, and IFE). The primary clone had declined in concentration from 0.8 g/dL to 0.4 g/dL while the second (new) clone could not be quantitated.
Lusia Sepiashvili, Ph.D.
Resident, Clinical Biochemistry
Maria Willrich, Ph.D.
Consultant, Clinical Biochemistry
Assistant Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine and Sciences