Hi Shelly,
Welcome to the forum. I'm sorry to hear about the concerns you have about possibly having multiple myeloma. However, it's great that you and your doctor are looking into the issue, because diagnosing the condition early, rather than late, is very helpful.
I would not jump to any conclusions based on the tests you've had so far. Yes, the elevated lambda free light chain level in your urine is a cause for some concern, and is the "low kappa/lambda ratio" (which I'm assuming refers to the ratio of your free light chain levels). But you really can't make a diagnosis of multiple myeloma based just on these results.
It sounds like you had a urine protein electrophoresis (UPEP) and also a urine immunofixation electrophoresis (IFE) done. Can you share with us the full results of those tests?
Also, did you have any testing done to measure your blood immunoglobulin (IgG, IgA, IgM, etc.) levels, and do you have any recent blood test results showing your hemoglobin, creatinine, and calcium levels?
(I'm assuming you didn't have any blood/serum free light chain testing done. If you did, those results would be really helpful to see.)
You can find a summary of the criteria for a multiple myeloma diagnosis in this article,
SV Rajkumar, "
New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014.
As you'll see in the article, the key issue for such a diagnosis will be whether there are clear signs that multiple myeloma is present and either causing damage to organs in your body, or very likely to be causing damage in the near future.
Based on the results of the urine testing that you've shared with us so far, it looks like some additional testing is probably warranted. Useful tests would include:
1, An x-ray or PET/CT survey of your skeleton to look for possible bone lesions
2. Blood (serum) free light chain and immunoglobulin level testing
3. Blood tests to measure your blood cell counts, hemoglobin, kidney function, and calcium
4. Blood (serum) protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE)
If these tests continue to show signs of myeloma, a bone marrow biopsy also will probably have to be carried out.
As I mentioned earlier, we can give you more feedback if you share some of the other test results you may have. But a final diagnosis really can't be made without the tests that I just mentioned.
The tests that I just mentioned can be ordered by your current physician. However, if it's necessary, you'll probably want the bone marrow biopsy to be done at a large hospital that does such biopsies on a regular basis.
Also, as you have additional testing done, if the results continue to suggest a diagnosis of multiple myeloma, you really should start thinking about getting a consultation with a doctor who specializes in multiple myeloma. If you live near a major cancer center, it may have one or more myeloma specialists, and your current doctor can refer you there for the additional testing that you need to have done. Also, if you need help finding a specialist, we'll be glad to make some suggestions. You can find a list of U.S. myeloma treatment centers here:
https://myelomabeacon.org/treatment-centers/Good luck!
