I just had some follow-up lab work and a bone survey done and noticed something that concerned me. There was a big jump in my kappa-lambda free light chain (FLC) ratio and I was wondering if that signified progression?
In May, my FLC numbers were as follows:
Kappa 15.9 mg/L
Lambda 8.4 mg/L
Kappa/lambda FLC ratio: 1.89
This month, my FLC numbers were as follows:
Kappa: 20.2 mg/L
Lambda: 5.5 mg/L
Kappa-lambda FLC ratio : 3.67
Should I be concerned about this? My M-spike was stable at 1.7 g/dL and my IgG was also stable around 2200 mg/dL.
Thanks in advance.
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Concern about big jump in free light chain ratio
I wouldn't personally worry about this until you have another 2-3 lab results under your belt. I've had a 400% increase in my free light chain ratio that then simply returned back to it's previous normal range when I got re-tested 2 months later. Also, these numbers can really move like the tides over time ... both ebbing and flowing.
Like my specialist likes to say: "If you don't like your test results, just repeat them".
Like my specialist likes to say: "If you don't like your test results, just repeat them".
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Concern about big jump in free light chain ratio
Thanks Multibilly,
You know, I found an old thread by you where you graph your M-spike, FLC ratio, and IgG levels. I think I might make myself look at those graphs whenever I get anxious about number changes. It really does illustrate how these numbers can fluctuate over time.
Also I think I was concerned because the kappa and lambda numbers moved out of normal range for the first time when, in the past, they've both been in the normal range, but their values have kept my ratio out of normal range.
You know, I found an old thread by you where you graph your M-spike, FLC ratio, and IgG levels. I think I might make myself look at those graphs whenever I get anxious about number changes. It really does illustrate how these numbers can fluctuate over time.
Also I think I was concerned because the kappa and lambda numbers moved out of normal range for the first time when, in the past, they've both been in the normal range, but their values have kept my ratio out of normal range.
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Concern about big jump in free light chain ratio
Just a follow-up on the free light chain (FLC) ratio that had me worried. Just had labs done last week and the ratio is back down (previous numbers in parentheses).
Kappa 16.5 mg/dL (20.2)
Lambda 8.8 mg/dL (5.5)
Kappa / lambda ratio: 1.88 (3.67)
Kappa 16.5 mg/dL (20.2)
Lambda 8.8 mg/dL (5.5)
Kappa / lambda ratio: 1.88 (3.67)
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
Re: Concern about big jump in free light chain ratio
Were your numbers back down because you had more treatment, or do they fluctuate? My husband recently just had his numbers go up (while M-spike and IgA stayed the same). I am just trying to figure out if I should be worried.
Re: Concern about big jump in free light chain ratio
FC,
Glad to hear. You will get used to these fluctuations over time. If you start to graph your key lab results over time, regular fluctuations versus worrisome trends will become a lot easier for you to spot.
I hope you smolder a nice long time
Glad to hear. You will get used to these fluctuations over time. If you start to graph your key lab results over time, regular fluctuations versus worrisome trends will become a lot easier for you to spot.
I hope you smolder a nice long time
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Concern about big jump in free light chain ratio
Hi lrankin,
I'm smoldering and not considered high-risk enough to take part in any clinical trials exploring whether it's worth treating smolderers. So no, I'm not receiving (and have never received) any treatment. My FLC ratio went up on its own and went back down on its own. My other myeloma markers were stable.
The fact that your husband's M-spike and IgA were stable should be comforting. I don't think the doctors worry too much if one number moves a lot in one test result if the other myeloma markers remain stable.
I too was very worried, but this brief experience with fluctuation was a teachable moment for me; I can't get too worked up over one lab result (easier said than done, though) and I need to see evidence of a trend before wondering if I am progressing to active myeloma.
I didn't change any of the vitamins or supplements I'm taking. I didn't change my diet. They just fluctuated naturally.
As Multibilly said, if you start to graph your husband's numbers, you'll find there is a natural movement in lab numbers. It will also help to identify any change in trends that you might want to discuss with the doctors (i.e. it seems like successive FLC ratio results continue to go up and up).
I'm smoldering and not considered high-risk enough to take part in any clinical trials exploring whether it's worth treating smolderers. So no, I'm not receiving (and have never received) any treatment. My FLC ratio went up on its own and went back down on its own. My other myeloma markers were stable.
The fact that your husband's M-spike and IgA were stable should be comforting. I don't think the doctors worry too much if one number moves a lot in one test result if the other myeloma markers remain stable.
I too was very worried, but this brief experience with fluctuation was a teachable moment for me; I can't get too worked up over one lab result (easier said than done, though) and I need to see evidence of a trend before wondering if I am progressing to active myeloma.
I didn't change any of the vitamins or supplements I'm taking. I didn't change my diet. They just fluctuated naturally.
As Multibilly said, if you start to graph your husband's numbers, you'll find there is a natural movement in lab numbers. It will also help to identify any change in trends that you might want to discuss with the doctors (i.e. it seems like successive FLC ratio results continue to go up and up).
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FingersCrossed - Name: FingersCrossed
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Oct 2014 (Smoldering)
- Age at diagnosis: 44
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