[SAJJ]

High lambda free light chain level, no M-spike: meaning?

by SAJJ on Tue May 03, 2016 11:36 am

Hello,

I was wondering if anyone could help me decipher these labs. Everything else falls in the normal range. I have been through a lot since January this year. Blood work, scans, biopsy, etc. etc. etc. If you need more info, I'd be glad to answer any questions. Thanks <3

Free Kappa Lt Chains,S 11.03 3.30-19.40 mg/L
Free Lambda Lt Chains,S 27.68 5.71-26.30 mg/L (HIGH)
Kappa/Lambda Ratio,S 0.40 0.26-1.65

Creatinine, Serum 0.53 0.57-1.00 mg/dL

M-Spike Note: Not Observed

[JPC]

Re: High lambda free light chain level, no M-spike: meaning?

by JPC on Tue May 03, 2016 1:29 pm

Hello Sajj,

The lambda light chains are only slightly out of range. There is a natural fluctuation to the light chains. Based on this data alone, I do not think it indicates anything amiss.

Good luck to you.

[SAJJ]

Re: High lambda free light chain level, no M-spike: meaning?

by SAJJ on Tue May 03, 2016 2:10 pm

Over the course of 5 weeks, it went from 13 to 27. Is that still considered a normal fluctuation? Or does it matter as long as it falls within the normal range?

[JPC]

Re: High lambda free light chain level, no M-spike: meaning?

by JPC on Tue May 03, 2016 3:38 pm

Not a definitive answer, because I am not a doctor, but based on other posters, that could be normal.

Here is something else for you to look at. Kappa and lambda tend to bounce up and down together, so sometimes doctors look at the ratio. If they both had been moving up and down together, then the ratio would be more stable than either of the two light chains, that would also be a sign that things are normal. I understand that there could be considerable fluctuations in the light chains, and if you have not yet been diagnosed with actual multiple myeloma, I don't think it's anything alarming at all.

In a relapse setting, some doctors look at the light chains, particularly the ratio, as an early warning sign, but typically they wander much farther higher before any bad symptoms start.

Good luck.

[SAJJ]

Re: High lambda free light chain level, no M-spike: meaning?

by SAJJ on Tue May 03, 2016 3:58 pm

Thanks for reading.

Last edited by SAJJ on Wed May 04, 2016 12:36 pm, edited 1 time in total.

[Multibilly]

Re: High lambda free light chain level, no M-spike: meaning?

by Multibilly on Tue May 03, 2016 6:24 pm

SAJJ,

I can understand your frustration. But the good news is that these numbers don't seem to suggest what you would expect with the vast majority of multiple myeloma variations.

I don't know what city you are in, but it might be helpful to go to a large, well-respected facility such as the Mayo Clinic. Mayo uses a integrated-specialist-team approach and might be able to get to a diagnosis more quickly and reliably in your situation.

[SAJJ]

Re: High lambda free light chain level, no M-spike: meaning?

by SAJJ on Mon May 16, 2016 4:02 pm

I have a slight M-spike with elevated IgM lambda light chain (if I said that right) and I also have enlarged nodes all in the cervical neck region and one in my upper right lung.

Anyone else have enlarged nodes with MGUS? If so, did they get bigger over time or just stay enlarged with no issue? Or did they eventually go back down?

[Multibilly]

Re: High lambda free light chain level, no M-spike: meaning?

by Multibilly on Mon May 16, 2016 5:33 pm

SAJJ,

If you have a diagnosis of IgM-type MGUS (as opposed to IgA or IgG), there are some special considerations to keep in mind. Also, if your MGUS type is additionally "lambda-restricted" (that is, you have a diagnosis of IgM-lambda MGUS), you are slightly more likely to develop amyloidosis. You might want to read through this article:

Mikhael, J, "Ask the Hematologist: A Diagnostic Approach to Patients with an IgM monoclonal protein," The Hematologist, Sep 15, 2014 (full text of article)