[Kay]

Free light chain test results

by Kay on Sun Sep 30, 2012 12:50 am

Hi,

I received a copy of my last lab results and haven’t been able to find any explanation or reference range for the following test results:

Immunofixation
Electrophoresis, Urine
Free lambda light chains
Albumin, UPEP 58 [%]
Globulin Alpha 1, UPEP 3 [%]
Globulin Alpha 2, UPEP 12 [%]
Globulin Beta, UPEP 25 [%]
Globulin Gamma, UPEP 2 [%]

I am IgG Lambda MGUS with a skewed K/L ratio.

Kay

[Restlessrebel]

Re: Free light chain test results

by Restlessrebel on Mon Oct 01, 2012 11:09 pm

Hi, the only one I know is the following:

The normal ranges for Serum Free Light Chains (Freelite test) are:
Lambda FLC, 5.7-26.3 mg/L,
Kappa FLC, 3.3-19.4 mg/L
K/L ratio is .26-1.70.

I am not sure about the other ones you listed...sorry. But you may be able to look up the lab on line and see what their normal ranges are. I have done this before with quest diagnostics.

Good Luck!

[elizabeth104]

Re: Free light chain test results

by elizabeth104 on Tue Oct 02, 2012 7:03 am

Kay, I have the same question!

I don't really understand my 24 hour urine collection results either. My doctor has had me do the test this past April, July, September, and I have to repeat the test for my appointment in December. We never talk about those results at my appointments but I am a little concerned that there is something wrong since I keep repeating the test!

My last results showed that albumin was the only protein detected at 100% and no monoclonal protein detected. All the other categories say "See rest of report, unit not reported." Annoying! I think my a/g ratio has been low in the past - .33, .53. At least, according to google, I believe that is low....

From what I understand, it would be concerning if you have have monoclonal protein (m-spike) in the urine. I don't know what any of the other numbers mean...

[Dr. Ken Shain]

Re: Free light chain test results

by Dr. Ken Shain on Thu Oct 04, 2012 12:03 am

Whenever someone is diagnosed with a monoclonal gammopathy -- whether premalignant (MGUS) or multiple myeloma -- we need to follow their disease. The plasma cells producing the monoclonal antibodies can be measured indirectly in your blood and urine.- a measure of disease burden.

We use tests like SPEP and SIFE (serum protein electrophoresis / serum immunofixation electrophoresis) to measure the M-spike in your blood. Quantitative immunoglobulins (IgG, IgA, and IgM), serum free light chains (kappa, lambda, and the ratio) again in your blood.

Lastly, we also measure the M-spike in your urine (UPEP and UIFE). When being monitored for MGUS or in response to therapy these should be measured everytime you see you oncologist (every 6 month for MGUS, 3 months for smoldering myeloma, and with cycles of therapy for active disease).

Unfortunately, these tests are never (or at least rarely) resolved on the same day of the visit. Igs take an hour or two, SFLC a bit longer and the SPEP-IFE and UPEP-IFE 3 days- the IFE sometimes a little longer in commercial labs.

For positive SPEPs and UPEPs an abnormal band of M-spike will be listed. In your case, the amount of urinary monoclonal antibodies is too small to quantitate, but was seen by immunofixation.

[Kay]

Re: Free light chain test results

by Kay on Fri Oct 05, 2012 12:12 am

Thanks, Dr. Shain,

The urine test was a spot check test - not a 24 hour test that I assume would give better answers. A year ago there were no FLC in a 24 hour test; so I am assuming this is some sort of progression.

I am now seeing a hematologist who interned in Seattle at the UW and SCCA and I am also in the Natural History study at the NIH. I wasn't satisfied with amount of detail that I was getting from NIH; so I will see my local doctor in between the visits back East. I will then be checked every six months until we determine that I am stable and then would lengthen out doctor visits. I plan on getting another BMB for the cytogenics or FISH results. Unfortunately, I am one of those people who suffer from "need to know."

Thanks again, Kay