My husband was diagnosed May 2015 as IgA kappa. He had induction with Revlimid, Velcade, and dexamethasone (RVD), and then an autologous stem cell transplant (SCT) in October 2015. His numbers were looking good until today. See January and March numbers below.
These were 2 different labs. There has definitely been a change in the local labs. As I know, we look for consistency rather than exactness when comparing results from 2 different labs. If we err on the side off assuming the local labs are accurate in showing an increase, what could this mean?
Thank you.
January 4, 2016 (Moffitt)
His IgA was 128 (range 70 - 400).
Kappa was 7.06 (range 3.30 - 19.40)
His lambda/kappa ratio was 0.98 (range 0.26 - 1.62).
His m-spike 0.1 g/dL with a note that said "an abnormal protein in the form of monoclonal peak is observed in the beta zone. It is difficult to distinguish between the monoclonal protein and the background of normal beta."
Another note was "immunotyping / immunofixation electrophoresis demonstrates the presence of an IgA kappa monoclonal gammopathy."
March 4, 2016 (local lab)
His IgA was 116 (range 70 - 400)
Kappa was 42.74 (range 3.30 - 19.40)
Kappa/lambda ratio was 4.9 (range 0.26 - 1.62)
M-spike 0
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Re: Kappa light chain rise 6 months after auto SCT
Irankin,
You need to look at the trends in the numbers over time. Yes, this seems like a somewhat significant jump in the kappa free light chain between January and March (at least to me as a layman), but it could also just be a temporary blip and/or attributable to using a different lab for the free light chain tests. You also need to consider that you are still in a period where the immune system is still reconstituting itself and changes can and do occur during this time. I'm not a doc, but I bet your doc will say something like "let's wait and see what the next couple of lab tests show before jumping to any conclusions."
Also, note that IgA M-spikes are notoriously difficult to measure since other proteins live in exactly the same area of the SPEP graph that an IgA spike can occupy. This is why the lab report stated, "It is difficult to distinguish between the monoclonal protein and the background of normal beta."
You need to look at the trends in the numbers over time. Yes, this seems like a somewhat significant jump in the kappa free light chain between January and March (at least to me as a layman), but it could also just be a temporary blip and/or attributable to using a different lab for the free light chain tests. You also need to consider that you are still in a period where the immune system is still reconstituting itself and changes can and do occur during this time. I'm not a doc, but I bet your doc will say something like "let's wait and see what the next couple of lab tests show before jumping to any conclusions."
Also, note that IgA M-spikes are notoriously difficult to measure since other proteins live in exactly the same area of the SPEP graph that an IgA spike can occupy. This is why the lab report stated, "It is difficult to distinguish between the monoclonal protein and the background of normal beta."
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Kappa light chain rise 6 months after auto SCT
Multibilly,
I was hoping you would comment. I have searched the posts and see there have been similar questions and you have posted. Thank you for posting to my question.
I do hope to hear from others.
I was hoping you would comment. I have searched the posts and see there have been similar questions and you have posted. Thank you for posting to my question.
I do hope to hear from others.
3 posts
• Page 1 of 1