20 days after I had the Cytoxan, I had a quantitative serum IgA and SPEP done. I got the results back, finally. How can this be though? My IgA and m-spike are higher than they were before the chemo! I wrote to a well-known MM specialist, and here’s what he said:

One possibility is potential good news-that is that the Cytoxan actually destroyed and lysed myeloma cells, releasing IgA into your system and temporarily increasing the serum IgA level, which may now drop lower over the next few weeks.If that drop does not happen, then this does raise the question that transplant with high dose Melphalan may not work well. A modified protocol of some sort might be required.My suggestion is to follow closely off therapy for the time being.