[Perseverance]

Is loss of normal FLC ratio considered relapse?

by Perseverance on Tue Jan 29, 2013 12:08 pm

2 1/2 years out from SCT, on Rev 5mg maintenance. This months numbers are Kappa FLC: 19.44, Lamda FLC: 11.10 for a FLC ratio of 1.75 with the normal ceiling being 1.65. Creatinine is .73 and normally sits at .67. For what it's worth, last month's numbers were around 8 for the Kappa FLC and 6 for the Lamda FLC. All of the Immunoglobulin readings are at the bottom of the normal range. Any thoughts on if any of this means anything?

[Ron Harvot]

Re: Is loss of normal FLC ratio considered relapse?

by Ron Harvot on Tue Jan 29, 2013 1:36 pm

Your FLC numbers are either in the normal range or just over. You gave 2 months of data. The current month is showing an increase in the Kappa reading from 8 to 19.44. You also said you have been on maintanence for quite some time. (2 1/2 years post ASCT). If I was you I wouild be concentrating on a long term trend. If the numbers were stable but then jumped this past month, I would wait and see what the next month test shows. If it comes back down than it means nothing. If the Kappa number continues to go up and the ratio gets farther out from normal, then you should have a discussion with your oncologist. He should be seeing the same numbers as you are and will likely bring it up at your next appointment.

Ron

[Perseverance]

Re: Is loss of normal FLC ratio considered relapse?

by Perseverance on Tue Jan 29, 2013 3:38 pm

Both numbers tend to bounce from time to time. However, there has never been a trend of kappa rising and lambda suppression. What does a jump in both K-FLC and L-FLC indicate?

[Ron Harvot]

Re: Is loss of normal FLC ratio considered relapse?

by Ron Harvot on Tue Jan 29, 2013 5:16 pm

I don't really know and would hesitate giving an opinion, as I am not a Dr. . Again, see if your next test shows the same trends. If not then don't worry about. If you have another test that is up then discuss it with your oncologist. You are probably fearing a relapse but we always tend to put our worst fears out front.

Ron

[tpt]

Re: Is loss of normal FLC ratio considered relapse?

by tpt on Wed Jan 30, 2013 10:54 am

Im also not a doc but have asked similar question to my doc.

If both kappa and lambda go up, then it means that your body is reacting to something, whatever it is. If you have kappa myeloma, for example, it probably tells you that your myeloma is not progressing. There's something else going on.

If one goes up and the other goes down, then the abnormal number indicates activity. If your kappa is going up, and lambda is suppressed, it indicates that your myeloma (given you have kappa myeloma, for example) is active. The malignant one tends to suppress the normal one.

Hence, that's why the ratio is always calculated. You can have a normal ratio, but abnormal kappa and lambda readings, which probably indicates that you have another blood problems. abnormal ratio tells you about your myeloma activity.

But, kappa and lambda light chains only have a couple of hours of life. If the ratio is not that much abnormal, i'd just wait until the next readings to make a call. Definitely warn your onc, tho.

(Others feel free to correct me if im wrong.)

[Cmolinaro]

Re: Is loss of normal FLC ratio considered relapse?

by Cmolinaro on Wed Jan 30, 2013 2:06 pm

From my understanding, you cannot consider to be relapsing based off one month's set of data. According to my multiple myeloma specialist, they need to carefully monitor it over a 6 month period or so, to determine any sort of trends.