[Music] what does the quantitative immunoglobulin test measure in terms of quantitative immunoglobulins normally people have five different classes of immunoglobulins IgA IgG IgM IgD and IgE those last two the amount of protein in the blood normally is very very small unusual to have IgE myeloma there are some cases of IgG myeloma but suffice it to say most centers will measure the total amount of IgA IgG and IgM in a person's serum so often when a person has myeloma one of those two types i GA or IgG will be very elevated and the other two types or the other the other members in that those classes will be depressed so for example for the most common type of myeloma with an M spike IgG Kappa and that that accounts for about 60% of myeloma those patients might have a very high level of IgG totally measured and that the IgA and the IgM levels will be low IgM is kind of in a special class by itself there are on occasion people who have myeloma that makes an IgM monoclonal protein in general people who have a very high level of IgM don't have myeloma they fall into a category of what we call Waldenstrom's macroglobulinemia which is sort of like a low a low-grade lymphoma a slow-growing lymphoma or they might have something that's terms sometimes lympho plasma CITIC lymphoma basically sort of the same terms but they they they rarely have true myeloma so the quantitative immunoglobulin test measures IgG IgA and IgM and basically what this is measuring is the immunoglobulins that the body is making from plasma cells now this is important because a lot of the times in people who have multiple myeloma their immune system is compromised as a side effect of the myeloma cells themselves so we see a drop and IgA and IgM or we see a drop in IgG and those those are a sign that it could put the patient at risk of infections now I Gigi when we check it in the quantity of immunoglobulins it can it gives us the total amount of proteins in Munich other lines of that subtype that the plasma cells are making but it does not tell us if they are functional immunoglobulins or non-functional amino balance so it's always important than what we are checking quantitative immunoglobulins we also complement it with an S prep and Amina fixation so we can have a better idea of what percentage of those immunoglobulins are functional and which ones are actually being made by the cancer cells themselves and are not going to help us fight infections [Music]