Hi Joe,
Multibilly gave you a very good explanation. I just want to add a couple things.
While your kappa free light chain number is important, what's really most important for the free light chains is the ratio between your kappa free light chain number and your lambda free light chain number. So, in addition to the kappa number on your lab results, you should also have a lambda number and probably the ratio between the two, which is simply kappa/lambda. You want that ratio to be in the normal range, even if the kappa reading or lambda reading aren't.
Another thing is that the kappa/lambda free light chain ratio tends to go into the non-normal range more quickly than the m-spike when a person's multiple myeloma is beginning to progress (get worse). Conversely, the ratio tends to move back into the normal range more slowly than the m-spike as a person's myeloma responds to the treatment and the person gets better.
For example, my kappa/lambda ratio first went into the normal range about 7 months after my m-spike went to 0. So it may be the case that your kappa number is just slower to come down all the way into the normal range than your m-spike, and that's pretty common.
Finally, the kappa and lambda free light chain numbers do tend to bounce around a bit from month to month, partly depending on whether your immune system is fighting an infection. So a one month increase from 31 to 36 for your kappa number shouldn't be alarming. What's more important is the trend over 3-6 months.
I hope this, along with Multibilly's reply, is a help.
Best wishes to you. Please keep us posted on how things go.
Mike
Forums
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
Re: Why is my kappa free light chain level elevated?
Really good points Mike.
Joe, this is another good reason to chat this over with your doc and get his/her take directly.
Joe, this is another good reason to chat this over with your doc and get his/her take directly.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Why is my kappa free light chain level elevated?
Thank you both for your responses. Hard to talk with doctor because I don't understand him. lol My m-spike has been 0 for a year and that light chain has been never normal. It bounced around 31-36 for years. Thank both of you for taking the time to help 
JOE
JOE
Re: Why is my kappa free light chain level elevated?
Hi Joe,
I have the IgG kappa myeloma and I have undergone the Revlimid, Velcade, dexamethasone (RVD) induction treatment from December 2014 till about mid September, when the Velcade shots were stopped. My only markers are kappa and the kappa / lambda ratio.
My oncologist started the 'tapering off' of my chemo in August 2015 when my kappa was around 13-15 and dropping (that was 1,070 at the start of the treatment), first by stopping the Velcade shots. My kappa was still dropping for the next three 4-week intervals. Then the dex was dropped, my Revlimid was reduced to every alternate day (from the daily 3 weeks on and 1 week off) at the end of October 2015, and my kappa rose from the 12.5 level to 19.7, 27.7, 31.6 and 27.8 as of the last test on Tuesday, February 16, 2016. Some of the increase may be attributed to the flu shot and the pneumo supplemental vaccine I had November and December last year. My oncologist has been telling me to essentially just 'hang in there' and that there is nothing much to worry about.
When I asked specifically, my oncologist replied that 'yes, one can live with these levels' of kappa. My kappa / lambda ratio, which signifies the balance between the different free light chain types, rose from a mid-range 1.04 to 1.56, 1.87, 1.87 and 1.89 during these last few tests. Again, these are higher than the 'normal range' numbers, but they do not indicate any runaway 'monoclonal' activity (no single free light chain is being overproduced).
This is only one example and I am citing my oncologist's opinion in my particular case. It does seem that your oncologist, and a few other posts stating that the oncologists in those cases had advised their patients the same thing, that a kappa of around 30 was not a cause for alarm or a cause for changing the maintenance therapy.
I am quite happy that this lower level chemo (maintenance level of Revlimid without dex or Velcade) is so much more tolerable. The induction chemo became almost intolerable as time went by, and by the end of the 8th 4-week cycle, I was tired and exhausted almost all the time. I still have some muscle pain (down to soreness) if I lift any heavy objects, but I am able to play a weekly round of golf and carry out all my business and routine activities. There are some oncologists whot would raise my doses and add dex to get my kappa down to a single digit level, but it may not be worth the cost in the loss in quality of life.
Echoing what mikeb wrote, these levels bounce around a bit; they do rise when our immune system is fighting an infection.
K_Shash
I have the IgG kappa myeloma and I have undergone the Revlimid, Velcade, dexamethasone (RVD) induction treatment from December 2014 till about mid September, when the Velcade shots were stopped. My only markers are kappa and the kappa / lambda ratio.
My oncologist started the 'tapering off' of my chemo in August 2015 when my kappa was around 13-15 and dropping (that was 1,070 at the start of the treatment), first by stopping the Velcade shots. My kappa was still dropping for the next three 4-week intervals. Then the dex was dropped, my Revlimid was reduced to every alternate day (from the daily 3 weeks on and 1 week off) at the end of October 2015, and my kappa rose from the 12.5 level to 19.7, 27.7, 31.6 and 27.8 as of the last test on Tuesday, February 16, 2016. Some of the increase may be attributed to the flu shot and the pneumo supplemental vaccine I had November and December last year. My oncologist has been telling me to essentially just 'hang in there' and that there is nothing much to worry about.
When I asked specifically, my oncologist replied that 'yes, one can live with these levels' of kappa. My kappa / lambda ratio, which signifies the balance between the different free light chain types, rose from a mid-range 1.04 to 1.56, 1.87, 1.87 and 1.89 during these last few tests. Again, these are higher than the 'normal range' numbers, but they do not indicate any runaway 'monoclonal' activity (no single free light chain is being overproduced).
This is only one example and I am citing my oncologist's opinion in my particular case. It does seem that your oncologist, and a few other posts stating that the oncologists in those cases had advised their patients the same thing, that a kappa of around 30 was not a cause for alarm or a cause for changing the maintenance therapy.
I am quite happy that this lower level chemo (maintenance level of Revlimid without dex or Velcade) is so much more tolerable. The induction chemo became almost intolerable as time went by, and by the end of the 8th 4-week cycle, I was tired and exhausted almost all the time. I still have some muscle pain (down to soreness) if I lift any heavy objects, but I am able to play a weekly round of golf and carry out all my business and routine activities. There are some oncologists whot would raise my doses and add dex to get my kappa down to a single digit level, but it may not be worth the cost in the loss in quality of life.
Echoing what mikeb wrote, these levels bounce around a bit; they do rise when our immune system is fighting an infection.
K_Shash
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K_Shash - Name: K_Shash
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: November 2014
- Age at diagnosis: 67
14 posts
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