What are oligoclonal bands in myeloma?

What are oligoclonal bands in myeloma?

Oligoclonal just means, oligo means a few more than a couple. So normally in myeloma, we have a monoclonal protein band on electrophoresis. So it's like one sized protein made by the myeloma. Sometimes the patient may have biclonal like two different clones or occasionally triclonal, but when there's several or a few or more, we call that oligoclonal. And that can be and that's actually a good sign in most cases. So for example, if patients have gone through a stem cell transplant and three or four months later they have oligoclonal bands, that's actually a good prognosis. That means their immune cells, their immune system is reconstituting that. It’s a sign of reinvigorating all of their T cell function, immune function and B cell function, plasma cell function. So those cells are reactivating and producing immunoglobulins probably to either pathogens or vaccine. Even vaccines can cause these to show up as a response to the vaccines or infections just can show a sign that they're reacting their immune systems responding and reacting to that. So oligoclonal bands can be good, although it sometimes make things difficult to know. Is one of those part of the myeloma or is it not? And so sometimes we'll have to send off a special test. For example, we can send a sample to the Mayo Clinic for MASS-FIX to say, okay, is any of this there same band that they had from their myeloma in the past or is it unrelated? What subtypes are there and can I go from there? They usually gradually disappear. They might last for several months and as long as they're not steadily rising like a myeloma protein, then they're usually not of any concern.