CD40LG and neoplasm: For example, IgM responses are typically slow with monoclonal antibody-based therapy, as these agents selectively deplete the CD20+ B-cell component with sparing of the CD138+ plasma cell component [3]; transient increase in monoclonal IgM protein level (IgM flare) can occur following rituximab infusion [23]; in patients treated with bortezomib, tumor reduction in the bone marrow may not be proportional to the suppression of IgM levels [24].