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.
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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