[NC Deb]

MGUS, but high kappa/kambda ratio - cause for concern?

by NC Deb on Sat Mar 08, 2014 4:46 pm

Hi! I am a newly-diagnosed MGUS but it could be something more, once my 2 lytic lesions (spine) are checked out this week through c-scans. All my basic blood tests turned out fine, but my kappa/lambda ratio is high at 20.40. I am quite concerned, as it is IgM and I know that's trickier to treat. Feel rather helpless!

Thanks for any suggestions, etc. I will probably need a bone marrow biopsy soon as well.

-Deb : )

[Multibilly]

Re: MGUS, but high kappa/kambda ratio - cause for concern?

by Multibilly on Sat Mar 08, 2014 6:28 pm

Hi Deb,

How do you know you have IgM-type MGUS, if all your blood and urine tests are normal, except for your free light chains? I also seem to remember that mm-related lytic lesions are much more rare with IgM type myeloma, but I'm not 100% sure if I am remembering that correctly.

You would be well served to get a bone marrow biopsy to really get to the bottom of this. Glad to see you are also sorting out the lytic lesions via a PET/CT scan....I think the mocha flavored version of the barium sulfate concoction tastes the best

Best of luck to you.

[NC Deb]

Re: MGUS, but high kappa/kambda ratio - cause for concern?

by NC Deb on Sat Mar 08, 2014 7:13 pm

Multibilly, thanks for your reply. I guess I meant to say that my cbc and cmp were fine. My IFE showed an m spike of .30 (pretty low), but I have an abundance of Igm and a constriction of IgG (both kappa). I also have had numbness in 2 fingers for 7 months. The doctor feels it could even be Waldenstorn's (sp?), I guess after the ct scan, I should know something. I won't need the dye for the scan at least-yay. I'm wondering if people with MGUS have high ratios like mine? All this is new to me, so please forgive my many questions. Thanks!

[Multibilly]

Re: MGUS, but high kappa/kambda ratio - cause for concern?

by Multibilly on Sat Mar 08, 2014 8:11 pm

Ah, now I see. Yes, Waldenstrom macroglobulinemia (WM) could definitely be a possibility given you've got an elevated IgM and a high Kappa free light chain reading. The bone marrow biopsy will be critical in helping sort this out, including whether it might be multiple myeloma or WM and, if multiple myeloma, just what stage of multiple myeloma (including MGUS). Glad your doc is on top of all this.

[Dr. Jason Valent]

Re: MGUS, but high kappa/kambda ratio - cause for concern?

by Dr. Jason Valent on Sun Mar 09, 2014 4:13 pm

It seems your evaluation has been good. Most patients with IgM monoclonal proteins will have lymphoplasmacytic cell as the malignant cell as opposed to a plasma cell. Somewhat similar diseases although bone lesions are less common with Waldenstroms (lymphoplasmacytic lymphoma).

[NC Deb]

Re: MGUS, but high kappa/kambda ratio - cause for concern?

by NC Deb on Sun Mar 09, 2014 5:29 pm

Thank you, Multibilly and Dr. Valent. I appreciate your comments- this is such a helpful site. Hopefully, I will get a definite diagnosis within 2 weeks or so. Until then, I'll try to stay positive!

-Deb : )