[Ericabowman]

Jump in light chain numbers during treatment

by Ericabowman on Thu Jul 21, 2016 12:58 am

Hi!

I was diagnosed in April 2016 with smoldering multiple myeloma. It is impacting my kidney function (Fanconi syndrome), so I started treatment with Revlimid and dexamethasone in May. I've just started my third round.

The first round yielded positive results: a decrease in kappa light chain, IgG M-spike, and light chain ratios.

The results of the second round, with the exception of the M-spike which was stable, rose back up to about where they were in April, and my WBC, RBC, platelets and platelet ratio are now all below normal limits, which I understand to be a side effect of the treatment. My kidney numbers are still below what they need to be, but my renal doc says it takes time to impact those results.

For those of you who are smoldering and receiving treatment, is it common for the numbers I'm watching to fluctuate like this? I see my doc (a myeloma specialist) next week for a follow up. I know I'm in for years of this and I'm trying not to overthink things, especially if it's a common result to have results fluctuate like this.

Thanks!

-Erica

[Multibilly]

Re: Jump in light chain numbers during treatment

by Multibilly on Thu Jul 21, 2016 8:34 am

Hi Erica,

You don't say what the actual values of your serum kappa, lambda and the ratio have been over time. So, it's hard to comment, especially since free light chain numbers will naturally fluctuate in a healthy person.

Revlimid can also impact free light chain numbers, but you need to be looking at all what the actual kappa, lambda and ratio values are doing along with your CBC numbers. But since your WBC, RBC, platelets and platelet ratio are now all below normal, bone marrow suppression due to the Revlimid seems like a likely suspect. Again, having the actual history of free light chain numbers can help shed some additional light on this situation.

Also note that kidney function can impact free light chain numbers (if your kidneys aren't working well, then they won't process the free light chains as well, so the serum free light chain values can in turn rise).