[sv25]

Kappa increasing post ASCT

by sv25 on Sat Sep 21, 2013 3:22 am

Hi All,

I was diagnosed with Kappa Light chain Myeloma in August of 2012.
After 4 rounds of chemo (Revlimid+Dex+Velcade), my Kappa chains came down from 1100+ to 12 (on an average). I had ASCT in March of 2013 and I am on Revlimid 10 mg maintenance right now (since July 2013).
Four months post transplant, my Kappa chain have started to increase.

Jun 2013: Kappa: 10.5 Lamda: 8.29 Ratio: 1.27
July 2013: Kappa: 18.18 Lamda: 10.60 Ratio: 1.71
Aug 2013: Kappa: 24.37 Lamda: 18.30 Ratio: 1.33
Sep 2013: Kappa: 27.29 Lamda: 16.32 Ratio: 1.67


Needless to say the numbers are worrying me a lot. Have any of you seen increase in numbers so soon after the transplant ? Is this a relapse and did you start on any treatment at this stage ?
My other labs look good.

Thanks so much !

Last edited by sv25 on Sat Sep 21, 2013 9:21 am, edited 1 time in total.

[dnalex]

Re: Kappa increasing post ASCT

by dnalex on Sat Sep 21, 2013 4:59 am

Hello,

I can't tell you much else other than the reading of the result, but those numbers are only slightly out of normal range. The kappa/lambda ratio appears to be in normal range.

I would talk to your doctor to see what he/she thinks.

Best wishes.

[Dr. Jason Valent]

Re: Kappa increasing post ASCT

by Dr. Jason Valent on Sun Sep 22, 2013 3:01 pm

The light chain in this situation is always a bit difficult to assess. Some of the increase is from the reconstitution of the NORMAL immune system. If the ratio stays near the normal range and stable, I am less concerned about relapse and more confident that the increase in the absolute numbers is due to immune reconstitution.

great question