Hi Toni,
Great to hear that you finally got free light chain testing done.
You were right that one of the key uses of the free light chain ratio in MGUS patients is in determining their risk of progression to either multiple myeloma or amyloidosis. Alex explains the risk factors in the common Mayo model for MGUS risk of progression in this forum posting:
"
Re: Percent of MGUS patients that progress to multiple myeloma?", posting by dnalex in Beacon forum thread, Aug 14, 2014.
An free light chain ratio that is out of the reference range is one of the factors that can contribute to a higher risk of progression. Note, however, that even having one of the risk factors means that the risk of progression is still just 1 out of 5 (20 percent) within 20 years.
As Alex pointed out in his posting:
... the Mayo Clinic identified 3 factors that will influence progression from MGUS to multiple myeloma:
1. Non-IgG isotype
2. Serum M protein greater than 1.5 g/dL
3. Kappa/lambda or lambda/kappa ratio being skewed, or out of normal range.
For patients with 0 of these major risk factors, the risk of progression at 20 years is 5%. For patients with 1, the risk factor is 21%. For those having 2 of these conditions, it's 37%, and for those meeting all three of those criteria, it's 58%."
Hope this helps a bit. Let me know if you have any further questions.
