[oboeshans]

What is a high kappa free light chain level?

by oboeshans on Tue Feb 09, 2016 1:01 pm

I am 8 years post diag­nosis. IgG kappa light chain multiple myeloma. Since diagnosis, the markers that track my disease are M-protein, IgG, and kappa free light chains and these all rise and fall in sync. In the last 3 months, however, this has changed so that now my M-protein is relatively stable while my kappa free light chains and ratio have risen dramatically to the high­est they have ever been. Current treatment is Revlimid and dex in 21 day cycles.

At diagnosis:

IgG 5697
IgA 45
IgM 13
Kappa free light chain 147
Lambda free light chain 13.2
K/L free light chain ratio 11.1
M-protein 3.9
Beta-2 microglobulin 4.11

Now:

IgG 1222
IgA 37
IgM 17
Kappa free light chain 153
Lambda free light chain 9.9
K/L free light chain ratio 15.45
M-protein 0.63

I'm wondering if others have any experience or knowledge of this. I believe this is due to the myeloma changing and getting smarter. My doctor doesn't think it's of any concern, but I don't agree and think that all these kappa free light chains being passed through the kidneys could damage them and eventually cause renal failure. I'm also concerned that the free light chains would be deposited in other organs, such as heart and lungs.

What level of kappa free light chain would it take to create the problems I referenced above?
While a level of 153 for kappa free light chain is well above normal, is it really that high for someone with myeloma?

Thanks in advance for the information.

[Aclinkboca]

Re: What is a high kappa free light chain level?

by Aclinkboca on Sat Mar 19, 2016 11:43 pm

I am not a doctor, but I can tell you from my experience.

I was diagnosed with myeloma when I had a 90% compression fracture of my L3 back in December. I had no M spike or other high value, except the kappa light number, which was 1009 on February 2nd. With the Velcade, dex, and Revlimid, my values have changed me all the way down to 77. Your 157 is elevated but, from what I read, your IgA appears more of a concern from what I know and have read.

I wish you the best of luck with your therapy and decreasing your numbers.

[WV Farmgirl]

Re: What is a high kappa free light chain level?

by WV Farmgirl on Sun Mar 20, 2016 12:01 am

Irankin

Normal levels of serum free light chains are:

Kappa - 3.3-19.4 mg/L, or 0.33-1.94 mg/dL
Lambda - 5.71-26.3 mg/L, or 0.57-2.63 mg/dL
Kappa/lambda ratio - 0.26-1.65

(You have to pay attention to units with free light chain results. The test results we got from my husband's oncologist list a normal reference range for free kappa light chains as 0.33 - 1.94 mg/dL, while other labs seem to use 3.3-19.4 mg/L. That makes it hard to compare numbers and know what is normal and what is really high.)

For what it is worth, my husband's kappa chains were at 6790 mg/dL at diagnosis, after several months of taking very high doses of dexamethasone following a misdiagnosis. His kappa / lambda ratio was 66,400. At that time, the doctor didn't seem to be reacting as if kidney problems were imminent or inevitable. That may have been because we were focused on other symptoms which were providing clear reasons for treating his myeloma aggressively.

Hope this helps.

WV Farmgirl