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Blood work confused!!!!

by blair77 on Thu Jun 13, 2013 5:44 pm

My husband just started his 2nd month of RVD therapy and has the following bloodwork
Free Kappa Lt 14.71 mg/L
Free Lambda Lt. 21.52
Kappa/lambda ratio .68
My husband said the nurse didn't know if his M spike had decreased and it isn't listed on the SPEP
Protein-6.2
A/G ratio 2.0
Albumin -4.1
Alpha-1 .2 g/dl
Alpha-2 .6 g/dl
Beta absolute. .8 g/dl
Gamma absolute .5g/dl
Does this indicate if he is responding to the therapy or is the M spike the only way to tell? Any ideas why it is not listed? I left a message for the nurse but its after 5:30 so don't expect to hear anything. Any insight would be great!! :)

blair77
Who do you know with myeloma?: My husband
When were you/they diagnosed?: April 2013
Age at diagnosis: 43
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Re: Blood work confused!!!!

by terryl1 on Fri Jun 14, 2013 5:49 am

You need his baseline numbers for comparison.

terryl1
Name: Terry
Who do you know with myeloma?: self
When were you/they diagnosed?: August 10, 2011
Age at diagnosis: 49
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Re: Blood work confused!!!!

by blair77 on Fri Jun 14, 2013 8:19 pm

His original lights chains:
Kappa free 14.27
Lambda free 64.55
Kappa/lambda ratio 0.22

blair77
Who do you know with myeloma?: My husband
When were you/they diagnosed?: April 2013
Age at diagnosis: 43
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Re: Blood work confused!!!!

by terryl1 on Sat Jun 15, 2013 5:53 am

You should discuss all of this with your doctor and request all relevant results. You have provided only his baseline free light chain assay results. These now appear to be in the normal range.

Normal reference ranges: Kappa: 3.3-----19.4 mg/l

Lambda: 5.7----26.3 mg/l

Ratio: 0.26-----1.65

terryl1
Name: Terry
Who do you know with myeloma?: self
When were you/they diagnosed?: August 10, 2011
Age at diagnosis: 49
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Re: Blood work confused!!!!

by Nancy Shamanna on Sat Jun 15, 2013 8:44 am

Hi Blair77, It certainly looks like everything is trending downwards and heading in the right direction, but the kappa/lambda has to be interpreted by a doctor, as Terry noted. There are complicating factors, such as kidney involvement, which can effect this ratio. It could be that the M spike was not detectable, if they did do the SPEP test, which would be nice if you have a secretory form of multiple myeloma.
Best wishes, and I hope that everything is going well for your husband.

Nancy Shamanna
Name: Nancy Shamanna
Who do you know with myeloma?: Self and others too
When were you/they diagnosed?: July 2009
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Re: Blood work confused!!!!

by blair77 on Sat Jun 15, 2013 4:12 pm

Thanks Terry and Multibilly :) all this stuff is sooo confusing. We don't see the doctor again until the last week in June so I will ask him to explain then! :D

blair77
Who do you know with myeloma?: My husband
When were you/they diagnosed?: April 2013
Age at diagnosis: 43
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