M-spike drops drastically in 90 days any thoughts?

@dmdinapoli81, any update? What did the testing reveal?

My wife has LPL IgG Kappa with Kappa Free Light Chains. Her M-Spike does vary a bit and has generally been steady for 2.5 years but her kFLC have generally gone up. I would ask if your FLC have been checked recently and what is the ratio of kappa v lambda. If normal then immunoglobulins can go up and down I would ask for a recheck and from the same lab. Also any new m-spikes? It sounds like good news but you need the whole picture as if could just be a glitch, improvement or disease morphing. This is my opinion anyway.

@colleenyoung
So the weird thing is a WB MRI was done and found several lesions and I am waiting on the results from the follow up MRIs that were targeted to those locations in my spine. And my BMB was 9%. It’s all so weird, I know they call us the number watchers but I’m lost at this one.

The MRI results are probably the key now. A falling M-spike and IgG would usually be encouraging, but they don't always tell the whole story. The targeted MRIs should help determine whether those lesions are actually related to your plasma cell disorder or something else entirely. With a 9% marrow you're right on the MGUS/Smoldering Multiple Myeloma border, so I can understand why this feels confusing. Hopefully the follow-up imaging will put the blood results into context. Out of interest, has your calcium level been elevated at all, and how have your free light chains (kappa/lambda ratio) been? Those can sometimes provide additional clues alongside the MRI findings. With my wife they suspected MGUS, MM or SMM but when I checked the blood results her blood calcium levels were very normal so I asked them to check for LPL IgG as this was a better fit. So I am sure with the correct tests things will become clearer. The key is often hidden in the blood results marrow and imaging and your clinicians sound very competent. The type of cells in the marrow should also give them an indication of the underlying issue.
Jon

@dmdinapoli81
Wishing you the best...

I'm still in purgatory mode. MGUS 10 years ago, and SMM for 1 or 2 years (depending on the doctor). I have IgA Kappa high risk SMM with the 1q21 gain mutation. My kappa/lambda is 93, kappa is about 1,300 mg/dL, m spike 1.4, and BMB two years ago (when my numbers were 1/3rd of what they are now) was 15% deranged plasma cells. I don't have any CRAB symptoms based on bloodwork and a March PET scan that was clean (the SMM didn't even show up). Only symptom is some fatigue from kappa proteins flooding my kidneys (stay hydrated). My next BMB is in 3 days. I almost got on a clinical trial, but my eGFR was too low (they wanted 60 or high kidney function with the ImmunoPrism bispecific antibody trial for SMM). I'm a retired research scientist, so if you search using the various engines, preferentially look for peer reviewed, NIH, and other papers. Too much misinformation out there. Clinical trials info is at ClinicalTrials.gov. A good emotional support network is also important; hugs are an important part of cancer treatment. Also, lab results can be variable; I had blood drawn for my nephrologist and oncologist in June, same lab and other criteria, one was an eGFR of 33 and the other 38.