I have had been on a test trial. My M-spike is 0. My IgA is in range at 200 (in line). But my kappa free light chain level is 32. Been for a few months. Should be only 19.
Why is that?
Any thoughts would be appreciated.
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Re: Why is my kappa free light chain level elevated?
Joe,
Welcome to the forum.
I think for anybody to comment intelligently on this post, you really need to provide a history of your disease, whether you've ever had an M-spike, what trial you are on, and what your M-spike and free light chains and free light chain ratio have done over time (before treatment, after treatment, etc).
Welcome to the forum.
I think for anybody to comment intelligently on this post, you really need to provide a history of your disease, whether you've ever had an M-spike, what trial you are on, and what your M-spike and free light chains and free light chain ratio have done over time (before treatment, after treatment, etc).
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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?
My M-spike was 4.9 and my IgA was 5500. My M-spike now is 0 and IgA is 200. My free kappa has been going from 26 to 36 for the last three months. At one point it was 42, normal is 19.
I am on a trial with panobinostat, dex and Revlimid. My question is: why has my free kappa not fallen into the normal range?
Any thought would help.
I am on a trial with panobinostat, dex and Revlimid. My question is: why has my free kappa not fallen into the normal range?
Any thought would help.
Re: Why is my kappa free light chain level elevated?
You probably want to also go back and see what your lambda and free light chain ratio have been doing.
One possible explanation based on what you've said here is that you might be experiencing a phenomenon known as "light chain escape" - but only your specialist could say this for sure. See:
http://thebindingsite.com/lightchainescape
You might want to discuss getting some additional tests such as a BMB or PET/CT to see if there is an increase in your tumor burden.
Again, I'm not a doc, and this is just one possible explanation based on some pretty limited data. You should really vet any suggestion on this forum with your doc. Other folks on the forum might have some different ideas as to what might be going on.
One possible explanation based on what you've said here is that you might be experiencing a phenomenon known as "light chain escape" - but only your specialist could say this for sure. See:
http://thebindingsite.com/lightchainescape
You might want to discuss getting some additional tests such as a BMB or PET/CT to see if there is an increase in your tumor burden.
Again, I'm not a doc, and this is just one possible explanation based on some pretty limited data. You should really vet any suggestion on this forum with your doc. Other folks on the forum might have some different ideas as to what might be going on.
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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?
This is very interesting as I came online to research my kappa light chain increase and here is this post.
At initial diagnosis I was 2.4 g/dL (24 g/L) M-spike and IgA around 5500 and my kappa was around 20 and the ratio around 2.3 (approximate values based on memory).
I have received treatment and had an auto transplant. It's a little over a year later. I was briefly at zero M-spike for a few months and all figures in the normal range.
A few months ago my M-spike was 0.3 and my kappa light chains were 12.35 in the normal range. My kappa/lambda ratio was 0.65.
Now I am M spike 0.2 and kappa light chains jumped to 21.55 with a ratio of 1.08. So the ratio is still in the normal range but I do wonder about the big increase in kappa light chains.
I will be meeting with my doctor next week to discuss this.
At initial diagnosis I was 2.4 g/dL (24 g/L) M-spike and IgA around 5500 and my kappa was around 20 and the ratio around 2.3 (approximate values based on memory).
I have received treatment and had an auto transplant. It's a little over a year later. I was briefly at zero M-spike for a few months and all figures in the normal range.
A few months ago my M-spike was 0.3 and my kappa light chains were 12.35 in the normal range. My kappa/lambda ratio was 0.65.
Now I am M spike 0.2 and kappa light chains jumped to 21.55 with a ratio of 1.08. So the ratio is still in the normal range but I do wonder about the big increase in kappa light chains.
I will be meeting with my doctor next week to discuss this.
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kjpoppit - Name: Kim Nelson
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Sept. 19th, 2013
- Age at diagnosis: 47
Re: Why is my kappa free light chain level elevated?
I had scan. No tumors. I had a few years back a stem cell transplant. Lasted 2 weeks. Did nothing. Had my bone marrow. Nothing wrong there. I think the Revlimid and panobinostat, thank God, has lowered all the numbers for last 13 months, just kappa free light chain. Can't get that into normal range.
My doctor says he's not interested about it as long as myeloma is under control, M-spike stays at 0, and IgA stays in range, but I am hoping I can get kappa free light chain to cooperate and get in line again.
Thanks for replies.
My doctor says he's not interested about it as long as myeloma is under control, M-spike stays at 0, and IgA stays in range, but I am hoping I can get kappa free light chain to cooperate and get in line again.
Thanks for replies.
Re: Why is my kappa free light chain level elevated?
Also back in February 2011, my free kappa was 270.80 so it has gone down but never in the normal range. It goes between 29 and 35, I think normal is 19.
Any suggestions would help.
Thank you, Joe
Any suggestions would help.
Thank you, Joe
Re: Why is my kappa free light chain level elevated?
Again, it's useful to look at one's kappa, lambda and the FLC ratio, not just the involved FLC.
If you go back and graph all of the above, including the M-spike, it might become more obvious as to what trends are developing.
If you go back and graph all of the above, including the M-spike, it might become more obvious as to what trends are developing.
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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?
I have a hard time understanding anything about myeloma. I am not very educated. It's very hard for me, so maybe someone could explain my why my serum kappa free light chain level month to month is from 31 to 36, yet my m-spike is 0 for the last 12 months.
What does this all mean?
I am on a trial drug (panobinstat) with dex and Revlimid, which has done very well for me. It has brought my m-spike down from very high. All my other numbers are good and normal, but I don't undertstand why the kappa free light chain level is high and doesn't go down. My other free light numbers are normal.
Thank you all. If someone could answer, it would be great.
What does this all mean?
I am on a trial drug (panobinstat) with dex and Revlimid, which has done very well for me. It has brought my m-spike down from very high. All my other numbers are good and normal, but I don't undertstand why the kappa free light chain level is high and doesn't go down. My other free light numbers are normal.
Thank you all. If someone could answer, it would be great.
Re: Why is my kappa free light chain level elevated?
Hi Joe,
Yeah, all the science behind multiple myeloma can get to be very confusing.
Let me try to explain what I think may be happening in more basic terms.
Immunoglobulins (antibodies which help fight off disease) are made up of two building blocks: heavy chains and light chains. With most cases of multiple myeloma, the plasma cells which produce these immunoglobulins start producing non-functioning "dud" copies of the heavy chains, as well as extra free light chains.
The M-spike measures the amount of the dud heavy chains (in your case IgA-type heavy chains). The free light chain assay measures the total number of kappa and lambda free light chains in your system (in your case, the ones being produced in excess are of the kappa variety).
Usually, treatment knocks down the production of BOTH the dud heavy chain (IgA in your case) and the affected free light chain (kappa in your case) . But sometimes after treatment, a new cancerous version (or versions) of your plasma cells can evolve and start to produce only extra free light chains while not producing any dud heavy chains. When this happens, it is known as "light chain escape".
Unfortunately, the fact that your plasma cells are starting to produce extra kappa free light chains can sometimes mean that you are experiencing a relapse if the production of the extra free light chains gets to be too excessive.
But you should really talk this over with your doc since I am not a doctor and I am only guessing at what may be happening here.
Yeah, all the science behind multiple myeloma can get to be very confusing.
Let me try to explain what I think may be happening in more basic terms.
Immunoglobulins (antibodies which help fight off disease) are made up of two building blocks: heavy chains and light chains. With most cases of multiple myeloma, the plasma cells which produce these immunoglobulins start producing non-functioning "dud" copies of the heavy chains, as well as extra free light chains.
The M-spike measures the amount of the dud heavy chains (in your case IgA-type heavy chains). The free light chain assay measures the total number of kappa and lambda free light chains in your system (in your case, the ones being produced in excess are of the kappa variety).
Usually, treatment knocks down the production of BOTH the dud heavy chain (IgA in your case) and the affected free light chain (kappa in your case) . But sometimes after treatment, a new cancerous version (or versions) of your plasma cells can evolve and start to produce only extra free light chains while not producing any dud heavy chains. When this happens, it is known as "light chain escape".
Unfortunately, the fact that your plasma cells are starting to produce extra kappa free light chains can sometimes mean that you are experiencing a relapse if the production of the extra free light chains gets to be too excessive.
But you should really talk this over with your doc since I am not a doctor and I am only guessing at what may be happening here.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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