About a year ago I submitted a post regarding my increasing Kappa FLC assay. Dr. Voorhees applied criteria to my numbers and indicated that the increase did not meet disease progression significance. Now, one year later, my numbers appear to meet those criteria and I'm wondering what to do next.
Here is a bit of background: I was diagnosed with multiple myeloma In August 2010 and underwent treatment with Velcade and dex followed by an ASCT in January 2011. My kidney function before treatment was ~13 GFR and it now hovers around 37. I have had no maintenance therapy. The following is a sample of my FLC Assay results (in mg/L) :
March/11 Kappa 39.0 Lambda 16.3 Ratio 2.39
October/12 Kappa 44.4 Lambda 8.3 Ratio 5.35
November/13 Kappa 94.7 Lambda 12.9 Ratio 7.34
As you can see my numbers are increasing. What is recommended? I see my hematologist in early December so we will discuss my situation then.
Any advice would be greatly appreciated!
Earl McKenzie
Forums
5 posts
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coopershawk - Who do you know with myeloma?: No one else.
- When were you/they diagnosed?: August 2010
- Age at diagnosis: 64
Re: Free light chains slowly increasing - what next?
good question.
The ongoing increase in the light chain and ratio is suggestive of relapse. Given the way the disease has affected your kidney function, I think restarting treatment soon would be important.
As to what to restart treatment with, I would use Velcade and dex again.
The ongoing increase in the light chain and ratio is suggestive of relapse. Given the way the disease has affected your kidney function, I think restarting treatment soon would be important.
As to what to restart treatment with, I would use Velcade and dex again.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Free light chains slowly increasing - what next?
Many thanks Dr. Valent...I'll be seeing my hematologist in a few weeks. I really appreciate your response!
Earl McKenzie
Earl McKenzie
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coopershawk - Who do you know with myeloma?: No one else.
- When were you/they diagnosed?: August 2010
- Age at diagnosis: 64
Re: Free light chains slowly increasing - what next?
I'm in much the same boat as yourself. My Lamda has risen to 16.5 on a 2.63 mg/dl scale and the ratio is a low .044 in a .260 scale. 3 months ago I was at 4.30 and .230. My M1 and M2 are present and to small to quantify.
I believe I'm coming out of what remission I had and while I would prefer not too, I'm in better shape then I was when diagnosed. The fact they are checking my numbers every 90 days should give them a heads up and I won't have to endure what I did the first time.
The good doctor confirmed what I was told, that a second treatment of Velcade is possible and hopefully it will have the same results for us. I had prednisone with my Velcade.
I believe I'm coming out of what remission I had and while I would prefer not too, I'm in better shape then I was when diagnosed. The fact they are checking my numbers every 90 days should give them a heads up and I won't have to endure what I did the first time.
The good doctor confirmed what I was told, that a second treatment of Velcade is possible and hopefully it will have the same results for us. I had prednisone with my Velcade.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Free light chains slowly increasing - what next?
Good luck Wayne! I hope everything works out for you. I'll be seeing my hematologist in December so we'll see what he has to say.
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coopershawk - Who do you know with myeloma?: No one else.
- When were you/they diagnosed?: August 2010
- Age at diagnosis: 64
5 posts
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