[JBarnes]

Relationship between IgG and kappa FLC?

by JBarnes on Fri Apr 24, 2015 10:46 am

I've got IgG kappa myeloma, which I think is pretty common. I had a stem cell transplant in early 2013 and have been on maintenance Revlimid at 15 mg daily since. For the last two + years, my numbers have been steady for kappa (12 - 10 mdl); they were over 300 when I first got treated. My M-spike has held steady at 0.02 - 0.04 g/dL.

The problem I see is that my IgG levels have been creeping up since the transplant. My specialist and local oncologist don't seem to be at all concerned about the IgG and focus on the FLC numbers.

I'm confused as to the relationship between the kappa free light chain level and the IgG. I searched and could not find the answer to my question. If someone has already answered this and I didn't find it, please include the link in this topic thread.

I've provided my latest blood results as a reference.

Jerry.

Chemistries (Comprehensive Metabolic Panel)

Lab Test Result Range
Creatinine measurement, serum (Creatinine) 1 mg/dL 0.6-1.3
Chloride measurement (Chloride) 104 mmol/L 101.0-111.0
Urea nitrogen measurement (BUN) 10 mg/dL 8.0-21.0
Sodium measurement (Sodium) 139 mmol/L 135.0-145.0
Calcium measurement (Calcium) 8.7 mg/dL 8.3-10.2
Alkaline phosphatase measurement (Alk. phosph.) 77 U/L 45.0-117.0
Albumin measurement (Albumin) 3.7 g/dL 3.5-4.8
Protein measurement (Total protein) 6.9 g/dL 6.8-8.9
Potassium measurement (Potassium) 3.9 mmol/L 3.6-5.1
Bicarbonate measurement (CO2) 26 mmol/L 21.0-31.0
Glucose measurement (Glucose) 107 mg/dL 67.0-120.0

Other

Lab Test Result Range
Bilirubin, total measurement (Bilirubin, total) 0.7 mg/dL 0.2-1.5
Aspartate aminotransferase measurement (AST/SGOT) 24 U/L 15.0-41.0
Alanine aminotransferase measurement (ALT/SGPT) 30 U/L 16.0-61.0
(GFR non-African American, estimated) 83 mL/min/1.73m2
(GFR African American, estimated) >=90
Immunoglobulin G measurement (IgG, quant) 1360 mg/dL 767.0-1590.0
Immunoglobulin M measurement (IgM, quant) 17 mg/dL 37.0-286.0
Immunoglobulin A measurement (IgA, quant) 130 mg/dL 61.0-356.0
(K/L light chain ratio, free, serum) 3.53 0.26-1.65
(Kappa light chain, free, serum, mg/dL) 11.5 mg/dL 0.33-1.94
(Lambda light chain, free, serum, mg/dL) 3.26 mg/dL 0.57-2.63

[Ron Harvot]

Re: Relationship between IgG and kappa FLC?

by Ron Harvot on Fri Apr 24, 2015 3:58 pm

JBarnes,

You may want to look at the Wikilite site as it may answer your questions.

http://www.wikilite.com/wikilite/index.php?title=The_biology_of_immunoglobulins

Your light chain numbers (lambda and kappa) are both slightly elevated with an elevated ratio. However, they are not very high.

You said your IgG has been rising, but it appears to be in the normal range. IgM is low, but that is pretty typical with multiple myeloma patients.

I did not see anything that is alarming. A single measure of tests is not very revealing. You must look at several tests to see a trend.

[Ron Harvot]

Re: Relationship between IgG and kappa FLC?

by Ron Harvot on Fri Apr 24, 2015 5:12 pm

Here is another reference site for helping undersatnd sFLC results

http://www.thebindingsite.com/interpretation-of-freelite-results

Ron

[JBarnes]

Re: Relationship between IgG and kappa FLC?

by JBarnes on Fri Apr 24, 2015 11:28 pm

Thank you for the links. Even though my IgG is in normal range, it continues to rise where at some point it will be abnormal.

[blair77]

Re: Relationship between IgG and kappa FLC?

by blair77 on Fri Apr 24, 2015 11:58 pm

My husband has IgA myeloma and his IgA has creeped above range and goes up slightly each month. His kappa and lambda are both elevated with a normal ratio. However, he hold steady with no M spike and negative immunofixation since his transplant in 2013.

His myeloma specialist always seems unconcerned about the rising IgA. Immunoglobulins can rise for several reasons, which is why I "think" they tend to focus on the "myeloma" labs only.