Hi there. I recently posted about my mother, who had a SCT back in October 2013 and was just found to have two plasmacytomas - one orbital and one in her groin. I was told by her doctor that, despite the plasmacytomas, her most recent bloodwork came back normal. She is scheduled to start focal radiation on Monday.
However, I just got online access to her most recent lab test results and it showed that her free light chain (FLC) kappa was 440, FLC lambda 0.10, and FLC K/L ratio was 4400. Surely this does not constitute normal bloodwork, right?
Do these results point to an urgent need for systemic therapy (ie chemo) as opposed to focal radiation of the plasmacytomas for the next 5 weeks? Just wondering how abnormal and significant these values are.
She was diagnosed just a year ago, so I am still getting my head around the significance of all of these numbers. Please advise. Thanks so much.
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Re: High FLC K/L ratio, but only radiation planned - make se
Plasma cells within the plasmacytomas can lead to an abnormal kappa/lambda ratio by producing large amounts of proteins.
Plasmacytomas are highly radiosensitive, i.e. plasma cells at a given site can be easily killed by radiation therapy.
However, is important to establish the areas involved prior to deciding the form of therapy. In order to determine the extent of relapse, evaluation with a bone marrow biopsy and other imaging studies such as PET-CT scan can be helpful. Once the extent of the involvement by abnormal plasma cells has been established, the form of therapy, radiation vs. systemic (chemo) vs. sequential (radiation followed by chemo) can be decided.
Follow-up of monoclonal protein studies, including kappa/lambda ratio, would be useful to determine the response.
Plasmacytomas are highly radiosensitive, i.e. plasma cells at a given site can be easily killed by radiation therapy.
However, is important to establish the areas involved prior to deciding the form of therapy. In order to determine the extent of relapse, evaluation with a bone marrow biopsy and other imaging studies such as PET-CT scan can be helpful. Once the extent of the involvement by abnormal plasma cells has been established, the form of therapy, radiation vs. systemic (chemo) vs. sequential (radiation followed by chemo) can be decided.
Follow-up of monoclonal protein studies, including kappa/lambda ratio, would be useful to determine the response.
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Dr. Prashant Kapoor - Name: Prashant Kapoor, M.D.
Beacon Medical Advisor
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