[dianaiad]

Increase in free light chains - does it mean anything?

by dianaiad on Mon May 04, 2015 2:02 am

When I was diagnosed, two years ago, I didn't have an issue with my free light chains; dead normal, absolutely normal ratio.

I think that when I had a bone marrow involvement of 80% or so, I had a kappa light chain level of 3, and a lambda level of, oh, six? Something like that. Very low, and the ratio was 0.07.

My last blood test on this, however, had the kappa light chains at 31 and the lambda light chains at 30, with a ratio of 1.0.

I understand that for multiple myeloma, the ratio is a bit more important than the light chains, but ... what the heck is going on here? I have no idea whether these numbers are "a little high," or "run for the hills" high, and whether it means I need to look harder at kidney function (ohhh, nooo, give up CHOCOLATE? Horrors!)

Or what. Could someone give me a lesson on this? Thanks.

[Ron Harvot]

Re: Increase in free light chains - does it mean anything?

by Ron Harvot on Mon May 04, 2015 11:33 am

You may find this table helpful (it's originally from the website of The Binding Site, the company that makes the Freelite free light chain test).

Remember a single test does not mean anything. You must look at a series that shows a trend.

Ron

FLC Cases.png (11.68 KiB) Viewed 2314 times

[Cheryl G]

Re: Increase in free light chains - does it mean anything?

by Cheryl G on Mon May 04, 2015 12:27 pm

Hi Diana,

So nice to hear from you again. I hadn't seen you here in the forum for a while, and I was a little concerned that something might be wrong.

What units are your free light chains being reported in -- mg/L, or mg/dL?

If the units are mg/L, then your kappa and lambda levels are only slightly elevated. Here are the normal ranges for the kappa and lambda levels in mg/L. If your test results are in mg/dL, then the values for the normal ranges would be one tenth the values below.

Kappa: 3.3 - 19.4 mg/L
Lambda: 5.71 - 26.3 mg/L
Kappa-lambda ratio: 0.26 - 1.65

If the units used by your lab are, in fact, mg/L, then the fact that BOTH your free light chain levels are slight elevated, but your kappa-lambda ratio is normal, is probably a sign that you've had an infection. However, you probably should check your creatinine level to make sure your kidneys are okay.

I hope this helps a bit. Good luck!

[dianaiad]

Re: Increase in free light chains - does it mean anything?

by dianaiad on Mon May 04, 2015 2:11 pm

Thank you!

That's exactly the information I needed. As it happens, those measurements are mg/L.

I'm just trying to keep up with what I need to keep up with.

[Dr. Jason Valent]

Re: Increase in free light chains - does it mean anything?

by Dr. Jason Valent on Mon May 04, 2015 2:57 pm

I think this was answered with the good posts above.

Some of the "increase" in the current values may indicate improved normal plasma cell im­mun­o­globulin production. The increase in normal plasma cells leads to an increased pro­duc­tion of normal kappa and lambda light chains, which can slightly elevate the free kappa and lambda light chain levels.

With the normal ratio, things seem to be going very well with your disease control.

[dianaiad]

Re: Increase in free light chains - does it mean anything?

by dianaiad on Mon May 04, 2015 7:31 pm

Thank you, everybody.

I really do enjoy good news.

... and I'll freely admit that I REALLY appreciate it that, so far – except for the chemo and BMT, which made for an uncomfortable bunch of months – I've had a very, very smooth ride with this thing.

Knowing how lucky / blessed I am with it makes me feel a little guilty, y'know ... and suspicious. Not all the time, mind you: I'm too busy. But ... sometimes ...