Hi,
My serum free light chain results are
Serum lambda free light chain 82.62 UNITS (Normal 5.71-26.30) (UK)
Serum kappa free light chain 11.21 UNITS (Normal 3.30 -19.40)
Serum kappa/lambda FLC ratio 0.14 (Normal 0.26-1.65)
Anyone with good knowledge of sFLC tests know if the lambda is very high?
I am anaemic and have been for a year. I have bone pain in hip / back and ribs.
My calcium levels and renal function are ok.
I had a skeletal survey which showed a single ill defined lytic lesion on my skull (two years ago with no further tests on it) Also a bone marrow biopsy which all I was told was the results were good.
My M Spike has risen slowly over 3 years from 3g/l to 6 g/l.
I am IgA lambda and am considered to still have MGUS and also have multiple sclerosis -psoriatic arthritis - high platelets (which caused arterial embolisms a few months ago) pancreatitis - Raynauds disease. Am on blood thinners and beta blockers for tachycardia suffered since April.
I have a haematology appointment on Monday and would welcome any ideas of what questions to ask. I have been given very little information on my condition which I've had for 3 years (found when being tested for rib pain, then was diagnosed with MS) and often have to see different doctors who don't know my medical history.
Thanks for reading
Angelina
Forums
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Re: Free light chain level - what is too high?
Angelina,
The lambda free light chain value is somewhat high and your FLC ratio is also therefore somewhat out of range. But, you can't look at just those values to understand your situation.
You also need to look at the trend over time of all your markers to figure out what your current situation is. You also need to be looking hard at any potential end organ damage (lytic lesions, anemia, etc) and to figure out if they are multiple myeloma related or not. Also, remember that the standard SPEP test that is used to measure the M-spike on IgA patients can have accuracy issues (there are new tests such as the Hevylite Assay that can get around that).
I think I mentioned before that you would be well advised to follow through with some additional testing on the lytic lesion and to understand the origin of your anemia. These are both potential criteria for classifying you as having symptomatic multiple myeloma.
I would be asking:
1. What is my hemoglobin level? Is my anemia multiple myeloma related? How do you know?
2. Request a fresh set of images, given you have bone and back pain.
See https://myelomabeacon.org/forum/pet-scans-for-multiple-myeloma-t3687.html to get a better idea of your imaging options.
3. Why wouldn't we get my lytic lesion on my skull biopsied to verify if it is mm-related or not? (especially since I am already diagnosed as having MGUS).
The lambda free light chain value is somewhat high and your FLC ratio is also therefore somewhat out of range. But, you can't look at just those values to understand your situation.
You also need to look at the trend over time of all your markers to figure out what your current situation is. You also need to be looking hard at any potential end organ damage (lytic lesions, anemia, etc) and to figure out if they are multiple myeloma related or not. Also, remember that the standard SPEP test that is used to measure the M-spike on IgA patients can have accuracy issues (there are new tests such as the Hevylite Assay that can get around that).
I think I mentioned before that you would be well advised to follow through with some additional testing on the lytic lesion and to understand the origin of your anemia. These are both potential criteria for classifying you as having symptomatic multiple myeloma.
I would be asking:
1. What is my hemoglobin level? Is my anemia multiple myeloma related? How do you know?
2. Request a fresh set of images, given you have bone and back pain.
See https://myelomabeacon.org/forum/pet-scans-for-multiple-myeloma-t3687.html to get a better idea of your imaging options.
3. Why wouldn't we get my lytic lesion on my skull biopsied to verify if it is mm-related or not? (especially since I am already diagnosed as having MGUS).
Last edited by Multibilly on Fri Aug 29, 2014 9:26 am, edited 1 time in total.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Free light chain level - what is too high?
Thanks Multibilly. I know I have already asked similar questions on other threads. Will write these down to ask on Monday. That helps a lot ! 
Re: Free light chain level - what is too high?
Had appointment today. I got yet another doctor (although was a new consultant not registrar) and more blood tests for iron levels today.
More blood tests in a month for anaemia. No real answers as, although my notes were there, she couldn't access my electronic notes to check some old blood results to determine whether I was right when I said I had noticed a significant increase in sFLC. Should have brought my folder of my own notes, then I could have told her the numbers that need checking.
Iron tablets for my anaemia (although there's a chance they can make my bone marrow worse?). Still have MGUS according to her but she will take a look at sFLC results later and said I would need another BMB if have raised a lot since July (I couldn't remember numbers).
Is still very confusing as they are dealing with the MGUS and the platelet / thrombosis problem at the same appointment.
Waited a long time. As usual was the only young person at the myeloma clinic.
When I asked about the lytic lesion found two years ago, she said that is why they are keeping a close eye on me. Not very reassuring but I think that's just the way they deal with possibly smoldering myeloma in this hospital.
More blood tests in a month for anaemia. No real answers as, although my notes were there, she couldn't access my electronic notes to check some old blood results to determine whether I was right when I said I had noticed a significant increase in sFLC. Should have brought my folder of my own notes, then I could have told her the numbers that need checking.
Iron tablets for my anaemia (although there's a chance they can make my bone marrow worse?). Still have MGUS according to her but she will take a look at sFLC results later and said I would need another BMB if have raised a lot since July (I couldn't remember numbers).
Is still very confusing as they are dealing with the MGUS and the platelet / thrombosis problem at the same appointment.
Waited a long time. As usual was the only young person at the myeloma clinic.
When I asked about the lytic lesion found two years ago, she said that is why they are keeping a close eye on me. Not very reassuring but I think that's just the way they deal with possibly smoldering myeloma in this hospital.
4 posts
• Page 1 of 1