Thank you very much for your response. My Dr. just scheduled me for a bone marrow biopsy next week. I'm nervous about the progression and possible need for treatment.

Just for information only
Better to ask your doctor

An IgG of 5,845 mg/dL is very high (normal ~700–1,600). In smoldering myeloma, this usually means a high monoclonal protein burden and a higher risk of progression, even if there are no symptoms yet.

By itself, this number does NOT automatically mean active myeloma. Doctors still look for:
Bone marrow plasma cells %
Free light chain (FLC) ratio
CRAB features (calcium, kidneys, anemia, bone lesions)
MRI or PET-CT findings

However, with IgG this high, most doctors will:
Monitor much more closely (often monthly)
Recheck FLC ratio and marrow %
Consider MRI/PET-CT
Discuss high-risk smoldering myeloma and, in some cases, early treatment trials

High number = pay close attention, not panic. Close follow-up helps catch progression early, before organ damage.

🙏 Wishing strength and clarity to everyone walking this journey together.

An IgG level of 5,845 mg/dL is markedly elevated and, in the context of smoldering multiple myeloma (SMM), it is a significant finding.

An IgG of 5,845 mg/dL in smoldering myeloma means a high disease burden and a higher risk of progression, even if you feel okay right now. It does not automatically mean active myeloma, but it requires very close follow-up and sometimes early treatment discussions. 8. How doctors decide your real risk (the full picture)

An IgG of 5,845 mg/dL is only one piece. Doctors combine 3 main factors to classify smoldering myeloma risk:

🔹 A. M-protein level (you already know this)
• >3.0 g/dL = high risk
• Yours ≈ 5.8 g/dL → very high

🔹 B. Bone marrow plasma cells
• <10% → MGUS
• 10–60% → Smoldering myeloma
• ≥60% → Active myeloma (treatment needed)

👉 This number is critical. If you don’t know it yet, doctors usually repeat a marrow biopsy when IgG is this high.

🔹 C. Free Light Chain (FLC) ratio
• Normal: 0.26–1.65
• ≥20 → high-risk SMM
• ≥100 → active myeloma (even without symptoms)

The “2/20/20” risk model (very important)

You are considered high-risk smoldering myeloma if you have 2 or more of the following:

With IgG 5.8 g/dL, you already meet 1 major criterion.
• If one more factor is present → high-risk
• High-risk SMM has about 50% chance of progression in 2 years

Symptoms you should NOT ignore (even if labs are “stable”)

Call your doctor if you notice:
• New bone or back pain
• Increasing fatigue or shortness of breath
• Frequent infections
• Headaches, blurry vision (hyperviscosity)
• Foamy urine or swelling (kidney strain)

IgG 5,845 mg/dL = high disease burden.
You may still be smoldering, but you are close to thresholds where progression risk rises sharply.
This requires tight monitoring and clear planning, not casual watch-and-wait.