So, I'm still trying to understand what the high kappa light chains mean when everything else looks good. After all my tests:
24-hour urine normal
IgG normal
BMB 6.8 plasma cells
Mild excessive kappa light chains
M protein 0.3
All other blood tests normal
So, what does the 788 kappa mean?
My doctor is not concerned and says just keep going with Revlimid and dex.
So, I'm trying to understand what this means. Is there any other reason that I have high kappa light chains. Honestly, I just can't figure it out.
I'm not worried, since everything else looks good, but should I be considering changing treatment or just go with what he says? I'm not symptomatic. No new lesions, etc.
Does anyone have any ideas? Should I get a second opinion in a few months?
I certainly feel good and continue to do all my normal activities.
Forums
Re: Meaning of high kappa light chains?
Christina,
What are the units of measure for your Kappa free light chain and what is your Lambda value? I assume you are talking about a kappa value from a serum freelite chain assay test, not a urine test, right?
Also, what are the units of measure for your M-spike?
What are the units of measure for your Kappa free light chain and what is your Lambda value? I assume you are talking about a kappa value from a serum freelite chain assay test, not a urine test, right?
Also, what are the units of measure for your M-spike?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Meaning of high kappa light chains?
The values are:
788.24 mg/L
Lamba free 15.26 mg/L
M protein. 0.3 g/ dL
I'm just trying to figure this out. My doctor just said since I was not having any symptoms, and everything else looks good. Just keep on Revlimid / dex.
I just want to know: Why? And should I be more aggressive in adding Velcade in the mix?
I see him in March and will pursue, but I find sometimes others have had either a similar experience or can offer insight.
Thanks
788.24 mg/L
Lamba free 15.26 mg/L
M protein. 0.3 g/ dL
I'm just trying to figure this out. My doctor just said since I was not having any symptoms, and everything else looks good. Just keep on Revlimid / dex.
I just want to know: Why? And should I be more aggressive in adding Velcade in the mix?
I see him in March and will pursue, but I find sometimes others have had either a similar experience or can offer insight.
Thanks
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Christina - Name: Christina
- When were you/they diagnosed?: June2005
- Age at diagnosis: 52
Re: Meaning of high kappa light chains?
Hello Christina,
I can understand your frustration and concern.
I know that many of us already quizzed you extensively on your recent lab results back in this discussion here in the forum,
"Elevated kappa FLC & kappa-lambda FLC ratio - meaning?", forum discussion started Jan 14, 2015
so forgive us if we ask some questions and give you some feedback that may sound similar.
Your kappa level certainly seems quite high to me, so I was surprised when your doctor did not make any change to your treatment plan based on the results. At the same time, I realize your doctor has a much more complete picture of what is going on with you and your myeloma than we can have based on just a few lab results.
Still, I have some questions that may help us clear things up.
First, can you give us the reference ranges ("normal" ranges) for your free light chain test results? They often are reported along with your own results on the same report.
Second, can you give us at least your kappa results for a couple of tests going back, just so we can see how much of a change the most recent test result was?
With this additional information, perhaps we can give you some better advice.
I can understand your frustration and concern.
I know that many of us already quizzed you extensively on your recent lab results back in this discussion here in the forum,
"Elevated kappa FLC & kappa-lambda FLC ratio - meaning?", forum discussion started Jan 14, 2015
so forgive us if we ask some questions and give you some feedback that may sound similar.
Your kappa level certainly seems quite high to me, so I was surprised when your doctor did not make any change to your treatment plan based on the results. At the same time, I realize your doctor has a much more complete picture of what is going on with you and your myeloma than we can have based on just a few lab results.
Still, I have some questions that may help us clear things up.
First, can you give us the reference ranges ("normal" ranges) for your free light chain test results? They often are reported along with your own results on the same report.
Second, can you give us at least your kappa results for a couple of tests going back, just so we can see how much of a change the most recent test result was?
With this additional information, perhaps we can give you some better advice.
Re: Meaning of high kappa light chains?
What were your free light chain values and M-spike values from your previous couple of tests? What therapy were you on when you had those earlier tests?
I don't know if I have an answer for you, but I imagine somebody in the know would want to understand the short term history leading up these latest values.
Ooops ... I just saw that Cheryl asked my same question
Cheryl, by the way, I think the Freelite assay test is standardized across all labs and is one of the very few tests that has the same reference ranges regardless of where the test is performed. The only thing that varies in the lab reports are the units of measure. At least, I'm "pretty sure" about that point.
I don't know if I have an answer for you, but I imagine somebody in the know would want to understand the short term history leading up these latest values.
Ooops ... I just saw that Cheryl asked my same question
Cheryl, by the way, I think the Freelite assay test is standardized across all labs and is one of the very few tests that has the same reference ranges regardless of where the test is performed. The only thing that varies in the lab reports are the units of measure. At least, I'm "pretty sure" about that point.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Meaning of high kappa light chains?
Thanks, Multibility and Cherly.
My M-protein has been about the same 0.3 g/dL or 0.4 g/dL for quite a while. I've been on Revlimid / dex since August 2013. This is my 3rd time on Revlimid / dex (started after relapse in 2010).
Actually, the last time he did my light chains was over a year ago, and at that point they were 68 or in that range, so slightly high.
The weird thing is even my bone marrow biopsy shows only 6.8 plasma cells. And it says only mildly excessive kappa light chains.
I guess I'm just frustrated with what / why?
As he said, I have no symptoms currently so why change anything. But I am always proactive and just keep thinking should I be doing something different.
I guess I'll hope to get some clues and then when I see him in March talk about it.
My M-protein has been about the same 0.3 g/dL or 0.4 g/dL for quite a while. I've been on Revlimid / dex since August 2013. This is my 3rd time on Revlimid / dex (started after relapse in 2010).
Actually, the last time he did my light chains was over a year ago, and at that point they were 68 or in that range, so slightly high.
The weird thing is even my bone marrow biopsy shows only 6.8 plasma cells. And it says only mildly excessive kappa light chains.
I guess I'm just frustrated with what / why?
As he said, I have no symptoms currently so why change anything. But I am always proactive and just keep thinking should I be doing something different.
I guess I'll hope to get some clues and then when I see him in March talk about it.
-
Christina - Name: Christina
- When were you/they diagnosed?: June2005
- Age at diagnosis: 52
Re: Meaning of high kappa light chains?
Hello again Christina,
I know this might seem picky, but could you let us know what the report says is the normal range for the light chain levels you listed above?
Multibilly - The reason I'm asking is because I'd like to make 100 percent certain that we're discussing results from the Freelite assay. I'm not completely certain that's the case given that Christina's report is saying that the kappa light chain results are just "mildly excessive." I agree that the assay is standardized here in the U.S., so the reference range also should be the same from one lab to the next (adjusting for differences in units).
I know this might seem picky, but could you let us know what the report says is the normal range for the light chain levels you listed above?
Multibilly - The reason I'm asking is because I'd like to make 100 percent certain that we're discussing results from the Freelite assay. I'm not completely certain that's the case given that Christina's report is saying that the kappa light chain results are just "mildly excessive." I agree that the assay is standardized here in the U.S., so the reference range also should be the same from one lab to the next (adjusting for differences in units).
Re: Meaning of high kappa light chains?
Cheryl, no need to provide an explanation to me. I agree this sounds a bit peculiar and it would be good to double check.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Meaning of high kappa light chains?
So test results from January 8, 2015:
Kappa Lambda free with ratio ser
Kappa, free 788.24 mg/L, reference 3.3-19.4
Lambda, free 15.26, reference 5.7-26.3
Kappa/ Lambda free 51.65, reference 0.26-1.65
It was my bone marrow biopsy that said: Mildly excessive kappa light chains.
Geez, now I'm getting confused .... Sorry.
Kappa Lambda free with ratio ser
Kappa, free 788.24 mg/L, reference 3.3-19.4
Lambda, free 15.26, reference 5.7-26.3
Kappa/ Lambda free 51.65, reference 0.26-1.65
It was my bone marrow biopsy that said: Mildly excessive kappa light chains.
Geez, now I'm getting confused .... Sorry.
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Christina - Name: Christina
- When were you/they diagnosed?: June2005
- Age at diagnosis: 52
Re: Meaning of high kappa light chains?
So, these are indeed the standard serum Freelite chain assay results.
I'm not a doc, but it seems like one wouldn't want to take any further action or get a second opinion until your FLC results were re-confirmed by a second test. After all, March is not too far off.
My favorite quote from one of my docs is "If you don’t like your labs, just repeat them ... You’ll like them better a second time"
I'd be curious what others have to say.
I'm not a doc, but it seems like one wouldn't want to take any further action or get a second opinion until your FLC results were re-confirmed by a second test. After all, March is not too far off.
My favorite quote from one of my docs is "If you don’t like your labs, just repeat them ... You’ll like them better a second time"
I'd be curious what others have to say.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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