[mwarner1969]

Elevated FLC ratio due to higher kappa, lower lambda

by mwarner1969 on Wed Sep 09, 2015 9:56 am

Since transplant 2 years ago, my free light chains (FLCs) have both been high with a normal ratio. Over the last 6 months, they have both been decreasing. This draw the decrease has caused an ab­normal ratio for the first time in 2 years.

The ratio is up driven by a higher kappa (47) and lower lambda (27). However, at diagnosis the ratio was low because I am IgA lambda.

Any ideas why this could have happened? Has my myeloma switched to kappa?

Also SPEP and IFE both still negative.

[Ron Harvot]

Re: Elevated FLC ratio due to higher kappa, lower lambda

by Ron Harvot on Wed Sep 09, 2015 11:34 am

mwarner1969,

First of all, I am not a doctor so all I can give you is general information.

Below is a link to "The Binding Site" that gives a good general explanation of what the various serum free light chain (FLC) results indicate

http://www.thebindingsite.com/interpretation-of-freelite-results

You can access the table and the kappa / lambda data plot.

In both of the above mentioned, they indicate that persons with both high kappa and lambda read­ings, but with a normal ratio, are likely to have renal impairment. That is not the only diag­nosis, but it is one that is more common.

The fact that both of your light chains have been falling the last 6 months appears to me to be a positive development. I would not worry about the move that kappa is now higher than lambda but instead would focus on the both of the numbers falling. If they both return to the normal range that would be very encouraging.

Good Luck

Ron