[csue222]

High kappa-lambda ratio but no M-spike after treatment

by csue222 on Wed Feb 21, 2018 12:20 pm

After four months of treatment, my blood work showed an abnormal kappa-lambda ratio of 2.75, but no M-spike was detected (had been 0.2). What does this mean?

I won’t see my doctor for two weeks.

Thank you.

[Multibilly]

Re: High kappa-lambda ratio but no M-spike after treatment

by Multibilly on Wed Feb 21, 2018 1:24 pm

Hi csue222,

What were your actual kappa and lambda free light chain numbers? Also, what did your serum immunofixation result state?

[csue222]

Re: High kappa-lambda ratio but no M-spike after treatment

by csue222 on Thu Feb 22, 2018 6:02 am

Kappa 5.5 mgL
Lambda 2.0 mg/L
Ratio 2.75
Serum - “Evaluation is consistent with an acute inflammatory pattern.”

[Multibilly]

Re: High kappa-lambda ratio but no M-spike after treatment

by Multibilly on Thu Feb 22, 2018 9:12 am

First off, I'm going to assume that the normal FLC ranges listed in your lab report are as follows:

3.3 to 19.4 mg/L kappa free light chains

5.71 to 26.3 mg/L lambda free light chains

0.26 to 1.65 ratio of kappa/lambda

So, if that's right, a low lambda FLC level (which is what is causing your high FLC ratio) along with a normal kappa FLC level, accompanied by a high FLC ratio can suggest bone marrow suppression. Bone marrow suppression is a common side effect of myeloma drugs such as Revlimid, etc.

Obviously a good topic to discuss further with your oncologist.

Also, note that the statement "“Evaluation is consistent with an acute inflammatory pattern" doesn't exactly sound like what I would expect from a serum immunofixation test, but rather a summary of an overall set of blood tests. Was that the only thing communicated on your serum immunofixation test report?

[csue222]

Re: High kappa-lambda ratio but no M-spike after treatment

by csue222 on Thu Feb 22, 2018 9:28 am

Your assumptions of norms is correct. Yes, that was the only statement.