We just discovered that my husband has celiac disease. Bloodwork also showed an M protein in his blood. After more bloodwork, we discovered his lambda / kappa ratio is elevated at 2.24.
X-rays showed lesions on both shoulders as well as skull. MRI done on biggest lesion to help inform biopsy. We learned on Friday that the largest shoulder lesion was benign. The doctor canceled the biopsy. We have a visit with the oncologist on Tuesday.
What could this possibly mean? Can you have MGUS or multiple myeloma with benign lesions?
So confused and hard waiting with little information.
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Re: High lambda-kappa ratio with benign bone lesion
Hi Rose,
I would suggest discussing getting a PET/CT scan when you see the oncologist. As far as I know, accurately determining whether a lytic lesion is cancerous or not via an MRI is an imperfect art (although the MRI lesion grading systems are fairly good at this). However, a PET/CT will leave you with little doubt on that count. And, of course, there is always the option of following through with a biopsy to get to the bottom of all this. In any case, it's probably good that your doc is letting an oncologist make the call on the next steps here.
Do you know the level of the M-protein that was found in his blood? The M-protein may be listed as an abnormal protein, M-protein, paraprotein, M-spike or something similar on the serum protein electrophoresis test.
It would also be useful to know if his calcium, creatinine and hemoglobin levels are all within normal ranges. You can find these values on the comprehensive metabolic panel and CBC test results.
Also, it would helpful to know his actual serum free light chain values, not just his ratio.
Knowing all the aforementioned lab values will help those on the forum better understand just what you might be dealing with here.
I would suggest discussing getting a PET/CT scan when you see the oncologist. As far as I know, accurately determining whether a lytic lesion is cancerous or not via an MRI is an imperfect art (although the MRI lesion grading systems are fairly good at this). However, a PET/CT will leave you with little doubt on that count. And, of course, there is always the option of following through with a biopsy to get to the bottom of all this. In any case, it's probably good that your doc is letting an oncologist make the call on the next steps here.
Do you know the level of the M-protein that was found in his blood? The M-protein may be listed as an abnormal protein, M-protein, paraprotein, M-spike or something similar on the serum protein electrophoresis test.
It would also be useful to know if his calcium, creatinine and hemoglobin levels are all within normal ranges. You can find these values on the comprehensive metabolic panel and CBC test results.
Also, it would helpful to know his actual serum free light chain values, not just his ratio.
Knowing all the aforementioned lab values will help those on the forum better understand just what you might be dealing with here.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High lambda-kappa ratio with benign bone lesion
Hi Multibilly,
Here's a little more info:
- Kappa: 119 mg/L
- Lambda: 52.5 mg/L
- Ratio: 2.27
- Calcium: 8.2 mg/dL
- Hemoglobin: 12.1
- Creatinine: 0.73 mg/dL
I've looked like crazy for numbers on the M protein, but can't find anything under the names you've provided. I will keep looking.
Does this help at all?
Here's a little more info:
- Kappa: 119 mg/L
- Lambda: 52.5 mg/L
- Ratio: 2.27
- Calcium: 8.2 mg/dL
- Hemoglobin: 12.1
- Creatinine: 0.73 mg/dL
I've looked like crazy for numbers on the M protein, but can't find anything under the names you've provided. I will keep looking.
Does this help at all?
Re: High lambda-kappa ratio with benign bone lesion
Well, there are few possibilities if you can't find an M-spike in any of the reports.
1.It could be that when they said they found "M-protein" in his blood, that only the serum immunofixation test detected the M-protein, but the serum electrophoresis test couldn't measure it. Serum immunofixation does a good job at detecting the presence of M-proteins, but it doesn't measure the M-spike value itself.
2. They only ran a serum immunofixation test, but they did not do a serum electrophoresis test.
3. It could also be that the monoclonal protein in the blood is only of the free-light-chain type and there is no heavy-chain M-spike. The serum immunofixation test results will tell you what kind of monoclonal proteins it found and whether it is of the heavy / light chain (e.g. IgA kappa) or light-chain-only (e.g. lambda) variety. So, it would be good to look at exactly what the immunofixation test results said.
4. Also, if you are looking at your results online, sometimes the M-spike value isn't included in the online version of the lab report. Also, the M-spike is sometimes reported in a separate notation on the serum electrophoresis test results
The creatinine and calcium levels both look good. Depending on what the normal range is for hemoglobin in your particular report, it looks like he might be slightly anemic (but not enough to signal symptomatic multiple myeloma)? And it looks like the kappa / lambda free light chain ratio is just a tiny bit elevated because the lambda free light chain value is just slightly below normal.
So, maybe the lesions are indeed benign given your other lab results, which would be great news. In any case, it's good you are following up with an oncologist to get some professional closure.
1.It could be that when they said they found "M-protein" in his blood, that only the serum immunofixation test detected the M-protein, but the serum electrophoresis test couldn't measure it. Serum immunofixation does a good job at detecting the presence of M-proteins, but it doesn't measure the M-spike value itself.
2. They only ran a serum immunofixation test, but they did not do a serum electrophoresis test.
3. It could also be that the monoclonal protein in the blood is only of the free-light-chain type and there is no heavy-chain M-spike. The serum immunofixation test results will tell you what kind of monoclonal proteins it found and whether it is of the heavy / light chain (e.g. IgA kappa) or light-chain-only (e.g. lambda) variety. So, it would be good to look at exactly what the immunofixation test results said.
4. Also, if you are looking at your results online, sometimes the M-spike value isn't included in the online version of the lab report. Also, the M-spike is sometimes reported in a separate notation on the serum electrophoresis test results
The creatinine and calcium levels both look good. Depending on what the normal range is for hemoglobin in your particular report, it looks like he might be slightly anemic (but not enough to signal symptomatic multiple myeloma)? And it looks like the kappa / lambda free light chain ratio is just a tiny bit elevated because the lambda free light chain value is just slightly below normal.
So, maybe the lesions are indeed benign given your other lab results, which would be great news. In any case, it's good you are following up with an oncologist to get some professional closure.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
4 posts
• Page 1 of 1