Hi,
My mother was diagnosed with myeloma. And we were told that the test which diagnosed myeloma was the 'free light array test'. I think she was diagnosed with kappa myeloma. The kappa light chain array was 4000+ and the ratio was around 313 when she was diagnosed. Then she undergone the treatment.
Now, we have done the 'free light array test' again recently. Now the counts are: kappa light chain = 40, lambda = 19. And the ratio is around 2.1.
If anyone can help me out as to what does this new test result indicates. According to the theory it should be under control now (I am not a person who belong to medical line but from the knowing i have till date for this) and I really hope so it is.
How good this figures are for us? And what should we interpret and react to this? Should we stop those injections in the vein? (Because she used to have weakness, skin and other side effects because of that.)
Thank you for your help in advance.
Best regards,
Ankit.
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Re: Kappa / lambda ratio - low enough to stop treatment?
I have light chain only myeloma kappa restricted. You should be very pleased as it indicates that the response has been great and very close to normal.....a 99% drop in the kappa light chains! A bone marrow biopsy will ultimately be done to further evaluate the response and check for minimal residual disease, etc. Good luck.
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terryl1 - Name: Terry
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 10, 2011
- Age at diagnosis: 49
Re: Kappa / lambda ratio - low enough to stop treatment?
A normal FLC Assay
Kappa: 3.3-19.4
Lambda: 5.71-26.3
Ratio: .26-1.65
Your mother is making great progress but her numbers are still not in the normal range. I am sure her oncologist will want to continue treatment. Like Terry I have light chain myeloma. I too responded well to initial treatement and have had normal/near normal range numbers now for over 4 years. However, I am still on a maintenance dosage of Velcade and Dex and probably will continue to be.
You can have a normal FLC but still not have healthy marrow. She should be having a full chemistry panel as well as a CBC and immunoglobulin tests. Often with multiple myeloma there is a suppression of one or more of the immunoglobulins. Wih me my IgA count is always below normal. (I have IgG Kappa light chain myeloma). That make me more prone to infections. People also tend to run lower white cell counts and hemoglobin or hematocrit counts may be low. Some of that is due to the meds and some of it is due to the multiple myeloma.
Her results are very encouraging and that is great. Hope she continues the progress.
Ron
Kappa: 3.3-19.4
Lambda: 5.71-26.3
Ratio: .26-1.65
Your mother is making great progress but her numbers are still not in the normal range. I am sure her oncologist will want to continue treatment. Like Terry I have light chain myeloma. I too responded well to initial treatement and have had normal/near normal range numbers now for over 4 years. However, I am still on a maintenance dosage of Velcade and Dex and probably will continue to be.
You can have a normal FLC but still not have healthy marrow. She should be having a full chemistry panel as well as a CBC and immunoglobulin tests. Often with multiple myeloma there is a suppression of one or more of the immunoglobulins. Wih me my IgA count is always below normal. (I have IgG Kappa light chain myeloma). That make me more prone to infections. People also tend to run lower white cell counts and hemoglobin or hematocrit counts may be low. Some of that is due to the meds and some of it is due to the multiple myeloma.
Her results are very encouraging and that is great. Hope she continues the progress.
Ron
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Kappa / lambda ratio - low enough to stop treatment?
FYI. My lab uses a different decimal now, why I don't know/
Kappa .3300- 1.94 mg/dl, Lambda ,5700- 2.63 mg/dl, Ratio 2600-1.65
Kappa .3300- 1.94 mg/dl, Lambda ,5700- 2.63 mg/dl, Ratio 2600-1.65
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Kappa / lambda ratio - low enough to stop treatment?
Thank you all for your valuable input.
For the bone marrow biopsy, I would like to put some figures here to help you out guiding me precisely on this.
She had a bone marrow biopsy before the treatment, and the number of plasma cells at that time were <1%. Which i think was a better number at that time (before the treatment).
Is it necessary to have a bone marrow biopsy test again? (it would be very painful for her to have that bone marrow test).
Please advice.
Best Regards,
Ankit.
For the bone marrow biopsy, I would like to put some figures here to help you out guiding me precisely on this.
She had a bone marrow biopsy before the treatment, and the number of plasma cells at that time were <1%. Which i think was a better number at that time (before the treatment).
Is it necessary to have a bone marrow biopsy test again? (it would be very painful for her to have that bone marrow test).
Please advice.
Best Regards,
Ankit.
Re: Kappa / lambda ratio - low enough to stop treatment?
Ankit,
I don't think another bone marrow biobsy would be advisable at this time.
Besides the FLC Assay they should run a Serum Protein Electrophoresis (SPEP) to see if she has a measurable M spike. In conjunction with the SPEP, immumofixation is usually done to detemine if there is any excess protein. The later tells the type of protein that is in excess and the SPEP quantifies it. All of these run together will give a very good picture of how she is doing. They are all just blood tests, just a few more viles drawn so not a big deal.
She should have had a full body bone scan (x ray) done by now which would tell if there was any damage (leasions or holes) caused by the multiple myeloma. Also with the chemistry panel I mentioned before will look to see if her calcium levels are elevated which might indicate bone damage and kidney impairment. So a lot can be learned from simple x rays and blood tests.
Ron
I don't think another bone marrow biobsy would be advisable at this time.
Besides the FLC Assay they should run a Serum Protein Electrophoresis (SPEP) to see if she has a measurable M spike. In conjunction with the SPEP, immumofixation is usually done to detemine if there is any excess protein. The later tells the type of protein that is in excess and the SPEP quantifies it. All of these run together will give a very good picture of how she is doing. They are all just blood tests, just a few more viles drawn so not a big deal.
She should have had a full body bone scan (x ray) done by now which would tell if there was any damage (leasions or holes) caused by the multiple myeloma. Also with the chemistry panel I mentioned before will look to see if her calcium levels are elevated which might indicate bone damage and kidney impairment. So a lot can be learned from simple x rays and blood tests.
Ron
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Kappa / lambda ratio - low enough to stop treatment?
Hi Ankit,
My mother is also diagnosed with multiple myeloma. Her lab results are:
Kappa Light Chain =45.10
Lambda Light Chain = 6.56
K/L Ratio = 6.880
Please help me to find out the solution and kindly share where is the best treatment in India .
Wishing your mother a speedy recovery.
Best regards,
Vikas Sood
My mother is also diagnosed with multiple myeloma. Her lab results are:
Kappa Light Chain =45.10
Lambda Light Chain = 6.56
K/L Ratio = 6.880
Please help me to find out the solution and kindly share where is the best treatment in India .
Wishing your mother a speedy recovery.
Best regards,
Vikas Sood
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Vikas Sood
Re: Kappa / lambda ratio - low enough to stop treatment?
Hi Vikas
Try Dr. Abhay Bhave at Lilavati in Mumbai. Supposed to be the best.
Try Dr. Abhay Bhave at Lilavati in Mumbai. Supposed to be the best.
8 posts
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