My dad was diagnosed with multiple myeloma about two weeks ago. We didn't realize anything was wrong with him until he got a severe pain in his groin area while going up and down the ladder at work. He thought he pulled his groin on the job, but when we rushed him to the ER we were told that they suspected multiple myeloma. I had never even heard of the disease.
Upon being admitted to the hospital, my dad had severely elevated levels of calcium in his blood and his kidneys were beginning to fail. They realized he had a UTI (urinary tract Infection) and began treating him for that. He also had very low levels of potassium and magnesium, so they kept pumping him with IV's of these things.
The oncologist said he in fact did have multiple myeloma. They started him on Velcade injections twice a week, 10 Cytoxan (cyclophosphamide) pills on Mondays, and 10 steroid pills on Mondays. He was discharged after being in the hospital for a week and a day. They started his first week of chemo while in the hospital.
Upon being discharged, they said he had no specific diet - no more renal diet.
My question is regarding the severity of my dad's individual situation. I am trying to understand everything and the doctors will only answer specific questions after you have to yank the info out of them. The oncologist finally said, yes, he has Stage 3 multiple myeloma after I asked, "What stage is it? Is it Stage 3?". Also, after much pressure the doctor finally admitted that my dad only had 1 month to live at best without starting treatment immediately..
We are in the process of being transferred to another hospital and oncologist because of monetary issues, so my dad is not being monitored the way he should be.
I have obtained his medical records and have done a lot of research and I believe my dad has free kappa light chain multiple myeloma. (This is my own personal diagnosis, not the doctors). Am I correct? And what should I tell the doctors, what can I do to help?
This is what his labs read:
Beta Microglobulin: 10.00 (ref:< OR = 2.51)
Immunoglobulin A Level: 21 L (ref: 81-463)
Immunoglobulin G Level: 5893 (ref: 694-1618)
Immunoglobulin M Level: 18 L (ref: 48-271)
Free Kappa Light Chain, Serum: 4071.1 (ref: 3.3-19.4)
Free Lambda Light Chain, Serum: 7.8 (ref: 5.7-26.3)
Free Kappa/Lambda Ratio: 521.94 (0.26-1.65)
Clearly his kappa light chains are extremely elevated, his M protein is low, and the overall kappa / lambda ratio is high. Can someone please explain this all to me a little better, though.
Could these numbers be so elevated due to the fact that he did have a UTI at the time? Again, it has been about 3 weeks and they haven't run these tests again because of finances.. We are trying to get him set up with another doctor, but until then he can still get his Velcade injections through the hospital (nurses).
Thank you for your time and any information/advice ... anything you can offer.
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Re: Free kappa / lambda ratio?
Also, I just wanted to add that he has lost 60 pounds in the last year. He currently has a fractured hip, fractures in his spine, and ribs. He also seems to be very confused and even disoriented at times.
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Jennifer123
Re: Free kappa / lambda ratio?
Jennifer123,
There are treatments that can reduce the amount of calcium in the blood which would help with the disorientation,
There are treatments that can reduce the amount of calcium in the blood which would help with the disorientation,
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rickcrocetti
Re: Free kappa / lambda ratio?
I, too, was diagnosed with in 2010. Stage 3 plus, if there is one. Many fractured ribs, old new, and re-fractured. Multiple lesions in my skull. My primary was told my mother had this and insisted I have my gall bladder checked, it was that doctor who sent me for all the scans and within a week I was on Velcade, Revlimid, and steroids. It knocked me for a loop and I decided myself to remove one of the chemo meds. Every bone marrow was improving so I opted to reduce the Velcade and feel partially human.
Until recently things went quite good. I reduced the chemo meds when I read a lesser dose will be as beneficial with less side effects. I have severe neuropathy, bone pain, and all the other bothersome goodies that go along with this disease.
The doctors hope to give the chemo that is best for a long run with this disease.
Following every test and trying to figure this complex disease is just tiring. Don't waste good time on a terminal disease. It will take its own course and hope the medicine combination prolongs it.
I also refused a stem cell transplant as the amount of time weighed against the time spent, if you make it through, is minimal.
I am realistic, happy, and don't waste time feeling sorry for myself.
Confusion, fatigue, etc. are all side effects to deal with.
There are new meds out there and help, if you qualify.
Until recently things went quite good. I reduced the chemo meds when I read a lesser dose will be as beneficial with less side effects. I have severe neuropathy, bone pain, and all the other bothersome goodies that go along with this disease.
The doctors hope to give the chemo that is best for a long run with this disease.
Following every test and trying to figure this complex disease is just tiring. Don't waste good time on a terminal disease. It will take its own course and hope the medicine combination prolongs it.
I also refused a stem cell transplant as the amount of time weighed against the time spent, if you make it through, is minimal.
I am realistic, happy, and don't waste time feeling sorry for myself.
Confusion, fatigue, etc. are all side effects to deal with.
There are new meds out there and help, if you qualify.
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bmrazz1fv84
Re: Free kappa / lambda ratio?
Can someone tell me what my results mean? I have an appointment with the doctor on Friday, but was wondering if anyone knew what some of this means.
Kappa light chain free - 885.4
Lambda light chain free - 2.9
Free kappa / lambda ratio - 305.31
Thanks
Kappa light chain free - 885.4
Lambda light chain free - 2.9
Free kappa / lambda ratio - 305.31
Thanks
Re: Free kappa / lambda ratio?
Also, the reason for the testing was low red count and low white count.
Re: Free kappa / lambda ratio?
bronsteph2,
You have a very high kappa light chain level, and your kappa to lambda ratio is out of the normal range. Have you had any other tests done, such as bone marrow biopsy, MRI, and/or PET scan, as well as a larger panel of blood tests?
You have a very high kappa light chain level, and your kappa to lambda ratio is out of the normal range. Have you had any other tests done, such as bone marrow biopsy, MRI, and/or PET scan, as well as a larger panel of blood tests?
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Free kappa / lambda ratio?
To Jennifer
Sorry about your Dad.
You are confusing M protein levels with immunogloblin M levels. This is understandable. M protein levels correspond to a spike in ANY antibody level - but most typically IgG levels, which appears to be the case with your Dad. Note that his IgG levels are more than 4000 units about normal.
Immunoglobulin G Level: 5893 (ref: 694-1618)
Thus will likely translate into a high M spike probably around 4000, or so, of IgG. The IgM and IgA levels have nothing to do with the M-Spike here, and they are low because the cells making those antibodies are likely being suppressed by the high levels of cancerous IgG cells.
This is not atypical. Your Dad likely has IgG kappa-restricted myeloma - the most common form. I have it. His beta-microglobulin levels are high; they supposedly represent the severity of the disease. That said, this disease is highly individualistic. A stage 3 patient can go into complete remission, have a prospect of many, many years - and live for a cure nowadays. So keep the faith.
Sorry about your Dad.
You are confusing M protein levels with immunogloblin M levels. This is understandable. M protein levels correspond to a spike in ANY antibody level - but most typically IgG levels, which appears to be the case with your Dad. Note that his IgG levels are more than 4000 units about normal.
Immunoglobulin G Level: 5893 (ref: 694-1618)
Thus will likely translate into a high M spike probably around 4000, or so, of IgG. The IgM and IgA levels have nothing to do with the M-Spike here, and they are low because the cells making those antibodies are likely being suppressed by the high levels of cancerous IgG cells.
This is not atypical. Your Dad likely has IgG kappa-restricted myeloma - the most common form. I have it. His beta-microglobulin levels are high; they supposedly represent the severity of the disease. That said, this disease is highly individualistic. A stage 3 patient can go into complete remission, have a prospect of many, many years - and live for a cure nowadays. So keep the faith.
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McDonald
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