[DSMan]

High serum free light chain with normal total light chain?

by DSMan on Sat Nov 16, 2013 10:34 pm

My relative has high serum free lambda light chain 917 mg/L (ref: 5.7-26.3 mg/L) while their total lambda light chain levels are within normal limits 149 mg/dL (ref: 32-156). Their free light chain ratio is abnormally low 0.018, but the total light chain ratio is normal 1.9.

Does this have any significance?

I assume the fact that the majority of their lambda light chain is unbounded is abnormal?

[Ron Harvot]

Re: High serum free light chain with normal total light chai

by Ron Harvot on Sun Nov 17, 2013 12:34 am

The lambda free light chain is very high and the ratio is very low. That must mean the Kappa free light chain must also be high otherwise it does not make sense. I think you need to get this interpreted by your oncologist.

Here is a source for more information on the Free light chain tests.

http://www.wikilite.com/wiki/index.php/Implementation_and_interpretation_of_free_light_chain_assays#26.3._Use_and_interpretation_of_serum_free_light_chain_results

Ron

[DSMan]

Re: High serum free light chain with normal total light chai

by DSMan on Sun Nov 17, 2013 1:20 am

The ratio is Kappa to Lambda.

[DSMan]

Re: High serum free light chain with normal total light chai

by DSMan on Sun Nov 17, 2013 1:22 am

He is seeing the ocologist, but the Kappa Free LC is normal. The ratio is low because the lambda is high.

[Dr. Peter Voorhees]

Re: High serum free light chain with normal total light chai

by Dr. Peter Voorhees on Sun Nov 17, 2013 8:57 am

Dear DSMan,

A lambda light chain level that high indicates that there is a clonal population of plasma cells in your relative's bone marrow producing an excess of clonal free lambda light chain antibodies. This can indicate monoclonal gammopathy of undetermined significicance (MGUS), asymptomatic (also called smoldering) multiple myeloma or symptomatic multiple myeloma. Why was your relative tested for light chains in the first place?

Further evaluation will be necessary to sort out the different possibilities.

Good luck and please let us know if you have any other questions.

Thanks!

Pete V.

[DSMan]

Re: High serum free light chain with normal total light chai

by DSMan on Sun Nov 17, 2013 11:03 am

He had multiple lesions on the lumbar and thoracic vertebrae, ilium, and ribs. The doctors have already diagnosed him with multiple myeloma.

I was wondering if there was just any significance to the total light chain being normal, while the free light chain being very high, in terms of prognosis.

[Dr. Peter Voorhees]

Re: High serum free light chain with normal total light chai

by Dr. Peter Voorhees on Sun Nov 17, 2013 11:48 am

There should be no prognostic implications regarding those findings.

Good luck!

Pete V.

[DSMan]

Re: High serum free light chain with normal total light chai

by DSMan on Mon Nov 18, 2013 9:46 am

Dr Voorhees,

Thanks for the information.