[Kay]

Free lambda light chain in urine

by Kay on Sat Apr 14, 2012 12:16 am

I have a copy of my most recent tests and the UIFE states “One (1) band of Free lambda light chains.” What does one “band” mean in terms of quantity? My 24 hr UPEP test, 07/2011, has 3 mg/dL protein concentration and no Bence-Jones protein present. Does the light chain band mean some progression or more potential for kidney damage?
My serum kappa lambda ratio has changed from 0.10 to 0.12. Is there a correlation between the K/L ratio and the “band” showing in the urine?

Thanks, Kay
MGUS IgG Lambda

[suzierose]

Re: Free lambda light chain in urine

by suzierose on Sat Apr 14, 2012 9:45 am

Hi Kay,

You can find a lot of testing information on the http://www.myeloma.org site.

Regarding your urine IFE (UIFE).. it indicates the prescence/abscence of protein and tells what type of monoclonal protein when present.

Sometimes they use IFE (immunofixation) from serum, (blood) when the patient is non-secretory and the protein doesn't show in urine. Yours showed up in urine though.

The band on the IFE shows the TYPE of monoclonal fragment present. In your case the band appears at the point for lambda. Your multiple myeloma is showing monoclonal lambda fragments that are unattached to your Ig ( immunoglobuins.). Of the five types of immunoglobulins G, A, M, E, D..your monoclonal G immunoglobulins have lambda free chains unattached, thus your signature of IgG lambda.

In another patient the TYPE could show gamma, alpha, or kappa or it could show MULTIPLE types of monoclonal fragments floating around unattached. The test indicates WHAT is there not how much.

Your UIFE test result detected the presence of one TYPE. i.e. one band.

The free light chain tests that provides your kappa/lambda ratio tells HOW MUCH is there.
Correlation then would be for quantity and type, the kappa/lamba ratio tells you the ratio (quantity) of those 2 free chains and which is floating around unattached, over the norm. Whereas the UIFE identifies the type of free chain your monoclonal protein fragment is.
The free light chain test then can be used to monitor disease progression. It also tells whether a drug is working when the ratio (quantity) goes down or if the ratio goes up, that means the patient could be relapsing or refractory to the drug. It is highly sensitive and more accurate than a bone marrow test, which can be misleading depending on the site of the BM biopsy/aspiration as it can vary in terms of the number of multiple myeloma cells found at that site. The BM could be a hot spot for multiple myeloma cells or not. i.e. multiple myeloma plasma cells are not equally distributed in pelvic bone.


Here is a link for information on free light chains:
http://myeloma.org/ArticlePage.action?tabId=0&menuId=0&articleId=872&aTab=-1&tBack=&tDisplayBack=true

Here is a link for many tests they use to monitor multiple myeloma

http://myeloma.org/ArticlePage.action?tabId=1&menuId=204&articleId=3177&aTab=-1&gParentType=menuitem&gParentId=204&parentIndexPageId=107


Hope this helps.

[Kay]

Re: Free lambda light chain in urine

by Kay on Tue Apr 17, 2012 10:00 pm

Thanks, Suzierose,

I reread your links and found the following statement which is what I was trying to ask but didn't word correctly.

"The finding of Bence Jones protein in the urine of MGUS patients is associated with an increased risk of malignant evolution to multiple myeloma, therefore the serum free light chain levels in these patients may provide useful prognostic information."

I've done a lot of reading at times; but sometimes I'm ahead of my symptoms and test results and kind of flounder until I find something that makes sense with my test results..

Kay

[suzierose]

Re: Free lambda light chain in urine

by suzierose on Wed Apr 18, 2012 9:11 am

Hi Kay,

You're welcome!

I am happy the links provided the information you were seeking. I try not to excerpt what could be a negative response to the query, as it can be overwhelming. So, I am glad that you went to the link and found that answer, rather than me posting it.

Wishing you well and sending you blessings.