[tpt]

Kappa FLC & creatinine levels: do they indicate relapse?

by tpt on Mon Jun 20, 2016 4:33 am

Hi,

Our doctor is on holiday. We are very worried. The past several readings have been like this:

Mar 2015 kappa 27
Jun 2015 kappa 37
Nov 2015 kappa 38 creatinine 0.98
Feb 2016 kappa 32 creatinine 1.02
Jun 2016 kappa 42 creatinine 1.12 (normal 1.17)

Lambda free light chain level has always been on the normal range.

Dad had an autologous stem cell transplant in Aug 2013, and he did not have any maintenance after that. He is p53d, high-risk.

I am very concerned with the creeping creatinine level and of course his kappa free light chain level, though historically it has always been in the 30s range, even after transplant.

Could this be a relapse? I'm very worried.

Always praying hard. Anyway thanks for reading.

[Ron Harvot]

Re: Kappa FLC & creatinine levels: do they indicate relapse?

by Ron Harvot on Mon Jun 20, 2016 12:41 pm

I would hesitate calling it a relapse. The numbers show a slow increase that may necessitate the introduction of some treatment in the near future. These are not dramatic jumps that would put him into a full blown relapse.

What has his latest SPEP test shown? You did not mention that. Does he even have an M-spike?

Many times oncologists will wait until the patient is showing symptoms before re-starting treatment or at least show a jump in their M-spike. Even if treatment is reintroduced, it may just be one of the novel agents and dex as opposed to a full-blown induction type treatment.

[tpt]

Re: Kappa FLC & creatinine levels: do they indicate relapse?

by tpt on Mon Jun 20, 2016 10:09 pm

Hi Ron,

Thanks for the reply.

He does not have an M-spike. We have been monitoring his kappa free light chain level since diagnosis.

From what I read in the forums, some people had their kappa free light chain level up to 15,000 before having CRAB symptoms. But my dad only had about 500 when he fractured his T3 T4 and T6.

About the increase in creatinine level, does it indicate a heavier kidney works due to myeloma? His eGFR levels have also been steadily dropping from 90ish to 70ish following the increase of his creatinine level. He is 65 this year.

Thanks for the insight. We really appreciate it.

[Ron Harvot]

Re: Kappa FLC & creatinine levels: do they indicate relapse?

by Ron Harvot on Tue Jun 21, 2016 2:04 pm

The serum creatinine (Cr) is just one test that measures kidney function. Your father's test are still within normal limits. The other tests are the glomerular filtration rate (GFR), the blood urea nitrogen (BUN) and the BUN/CR ratio. If all of these tests are normal, then his kidney function should be fine. If they are all normal but trending up, I would have him discuss that with his oncologist. For your own peace of mind, bring your concerns up at his next oncologist appointment. Never be afraid to ask questions.