Monthly blood tests have been slowly increasing since January 2015. Currently on Revlimid and dexamethasone as maintenance.
In March, the lambda light chain was at 233. Now the April blood work just came back and the lambda jumped all the way up to 1313. Kappa is at 2.8.
We are wondering what this sort of increase in a short time means. We are all panicking after getting these results.
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JenAuck - Who do you know with myeloma?: Dad
- When were you/they diagnosed?: March 2014
- Age at diagnosis: 63
Re: Lambda free light chains - huge increase in one month
Jen,
I experienced a big jump in kappa light chains in one month while on Revlimid maintenance. Revlimid is not effective forever, and maybe this is an indication that this drug is at the end of its effectiveness for your dad. Your father's oncologist should be able to explain what all this means for your father.
I know for me it was a bit unsettling too. I felt it marked the end of one phase and the beginning of another, which it kind of is. Revlimid is one of the main drugs to treat myeloma and I believe the primary drug used for maintenance therapy and now is something that is not going to help me anymore. I learned that this does not mean it is time to panic yet though. There are still a number of other treatment options to be tried but I will miss the convenience of being able to take a pill.
I will be trying Kyprolis next, which means spending a 6 hours a week at the hospital having it administered through IV.
I experienced a big jump in kappa light chains in one month while on Revlimid maintenance. Revlimid is not effective forever, and maybe this is an indication that this drug is at the end of its effectiveness for your dad. Your father's oncologist should be able to explain what all this means for your father.
I know for me it was a bit unsettling too. I felt it marked the end of one phase and the beginning of another, which it kind of is. Revlimid is one of the main drugs to treat myeloma and I believe the primary drug used for maintenance therapy and now is something that is not going to help me anymore. I learned that this does not mean it is time to panic yet though. There are still a number of other treatment options to be tried but I will miss the convenience of being able to take a pill.
I will be trying Kyprolis next, which means spending a 6 hours a week at the hospital having it administered through IV.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Lambda free light chains - huge increase in one month
Thank you so much, Eric. My dad is going to be trying Kyprolis too. He is waiting for it to be approved by insurance. I know we are so blessed that there are other options to try! He had his stem cell transplant in August 2014. The Revlimid only worked for a few months after 
Before he had the transplant, he was on the Velcade, and he did respond to it. Since the Kyprolis is supposed to be a better version of the Velcade, we are hopeful for the same results!
All the best. We can stay in touch about the Kyprolis too, as it sounds like both you and my dad will be starting it around the same time!
Before he had the transplant, he was on the Velcade, and he did respond to it. Since the Kyprolis is supposed to be a better version of the Velcade, we are hopeful for the same results!
All the best. We can stay in touch about the Kyprolis too, as it sounds like both you and my dad will be starting it around the same time!
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JenAuck - Who do you know with myeloma?: Dad
- When were you/they diagnosed?: March 2014
- Age at diagnosis: 63
Re: Lambda free light chains - huge increase in one month
Good day Jen & Eric,
I have had 9 cycles of Revlimid and the best results were after the 4th cycle, where the lambda FLC was at 76 and since then it started to climb back up. After the 9th cycle, the reading was 172, so we decided to seek another treatment.
Unlike your Dad, Jen, and you, Eric, my doctor has decided that we should try Pomalyst (pomalidomide) and continue on low dose dexamethasone (20 mg once a week for now). My doctor did discuss Kyprolis, but unfortunately it is harder to be approved in Australia.
The plan is to start the pomalidomide treatment next week, Monday the 11th May.
This would be my 6th treatment regimen, as I have been treated with thalidomide(TCD) in 2010; after almost 2 year, we again tried (TCD) in 2011; Velcade in 2012/2013; autologous transplant in late 2013; and Revlimid from late August 2014 to April 2015.
All the best,
Sam
I have had 9 cycles of Revlimid and the best results were after the 4th cycle, where the lambda FLC was at 76 and since then it started to climb back up. After the 9th cycle, the reading was 172, so we decided to seek another treatment.
Unlike your Dad, Jen, and you, Eric, my doctor has decided that we should try Pomalyst (pomalidomide) and continue on low dose dexamethasone (20 mg once a week for now). My doctor did discuss Kyprolis, but unfortunately it is harder to be approved in Australia.
The plan is to start the pomalidomide treatment next week, Monday the 11th May.
This would be my 6th treatment regimen, as I have been treated with thalidomide(TCD) in 2010; after almost 2 year, we again tried (TCD) in 2011; Velcade in 2012/2013; autologous transplant in late 2013; and Revlimid from late August 2014 to April 2015.
All the best,
Sam
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SamM - Name: Sam
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 2009
- Age at diagnosis: 47
Re: Lambda free light chains - huge increase in one month
I relapsed on Velcade / Revlimid / dex last December, and then I started carfilzomib (Krypolis). I think the side effects are quite similar to Velcade, but with a little more immunosuppression. My absolute neutrophil count dropped as low as 1.4, below 0.5 - 1, you are "neutropenic", meaning that you are immune suppressed enough to be at risk of very severe infections and must take strict precautions. In my lab, a normal absolute neutrophil count is 2.4-7.6 (this can vary by lab machine).
Are any of you considering getting a port for your IV administration? I got one, and after it healed it was great!! I'm glad I did it.
Are any of you considering getting a port for your IV administration? I got one, and after it healed it was great!! I'm glad I did it.
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Tracy J - Name: Tracy Jalbuena
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2014
- Age at diagnosis: 42
Re: Lambda free light chains - huge increase in one month
Thank you for your reply Tracy. My dad has been on Kyprolis for two weeks now and his numbers continue to rise. He has a port and the chemo is every Thursday and Friday. The last two Saturday and Sundays he is experiencing horrible bone pain in his ribs and back. Very exhausted ( hard for him to sleep), and the last couple of days he has seemed a little confused. We are praying hard for the numbers to start dropping soon!
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JenAuck - Who do you know with myeloma?: Dad
- When were you/they diagnosed?: March 2014
- Age at diagnosis: 63
Re: Lambda free light chains - huge increase in one month
I've had something similar happen to me and am wondering what it means.
I was diagnosed in April 2015 with Stage 1 IgA multiple myeloma at 47 years old. I went through 4 months of induction therapy followed by an autologous stem cell transplant in October 2015. I have been in complete remission (without any maintenance) until now.
At my latest appointment, my doctor told me that my CBC and complete metabolic panel were all completely normal, as well as my beta 2 microglobulin. But there was a huge jump in my lambda light chain number (which has been normal for 2 1/2 years) and a decrease in the kappa lambda ratio (which also had been normal). Also my IgA is beginning to rise above the normal limits.
My doctor said that I could be at the start of a relapse, or just be in a smoldering-like phase for now. I have a bone marrow biopsy scheduled for next week.
So I'm also wondering what this might mean. I am pretty nervous and am hoping for some advice. Thank you!
I was diagnosed in April 2015 with Stage 1 IgA multiple myeloma at 47 years old. I went through 4 months of induction therapy followed by an autologous stem cell transplant in October 2015. I have been in complete remission (without any maintenance) until now.
At my latest appointment, my doctor told me that my CBC and complete metabolic panel were all completely normal, as well as my beta 2 microglobulin. But there was a huge jump in my lambda light chain number (which has been normal for 2 1/2 years) and a decrease in the kappa lambda ratio (which also had been normal). Also my IgA is beginning to rise above the normal limits.
My doctor said that I could be at the start of a relapse, or just be in a smoldering-like phase for now. I have a bone marrow biopsy scheduled for next week.
So I'm also wondering what this might mean. I am pretty nervous and am hoping for some advice. Thank you!
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PattiM - Name: Patti
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 47
Re: Lambda free light chains - huge increase in one month
Patti,
Sorry to hear your numbers may be going up. There won’t be enough information for you to make a decision on treatment until you have future lab results.
But you can read up on some of the treatment alternatives you will have if / when you reach that point. There have been so many new drugs approved recently that it can be a confusing decision. This site has a lot of patient experience with the various treatment alternatives.
Good luck,
David
Sorry to hear your numbers may be going up. There won’t be enough information for you to make a decision on treatment until you have future lab results.
But you can read up on some of the treatment alternatives you will have if / when you reach that point. There have been so many new drugs approved recently that it can be a confusing decision. This site has a lot of patient experience with the various treatment alternatives.
Good luck,
David
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Arizonan - Name: Arizonan
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: April 2010
- Age at diagnosis: 54
Re: Lambda free light chains - huge increase in one month
Hi Patti,
When you say your lambda levels went up a lot, can you be more specific? For example, what were your last one or two sets of free light chain results (date of test, kappa level, lambda level, and ratio) prior to the jump, and what were the date and results of your last test?
It also might be useful for comparison's sake to know what your free light chain levels were at diagnosis. That would give a sense if your myeloma is still similar to what you had at diagnosis, or if it is now different.
There are a lot of threads here in the forum with discussions related to changing free light chain levels. Just type "lambda" into the forum search bar and you're bound to find several discussion that will give you useful perspectives and insights. Here's one discussion that I found rather quickly:
https://myelomabeacon.org/forum/increasing-lambda-free-light-chain-numbers-t6891.html
Cheers!
When you say your lambda levels went up a lot, can you be more specific? For example, what were your last one or two sets of free light chain results (date of test, kappa level, lambda level, and ratio) prior to the jump, and what were the date and results of your last test?
It also might be useful for comparison's sake to know what your free light chain levels were at diagnosis. That would give a sense if your myeloma is still similar to what you had at diagnosis, or if it is now different.
There are a lot of threads here in the forum with discussions related to changing free light chain levels. Just type "lambda" into the forum search bar and you're bound to find several discussion that will give you useful perspectives and insights. Here's one discussion that I found rather quickly:
https://myelomabeacon.org/forum/increasing-lambda-free-light-chain-numbers-t6891.html
Cheers!
Re: Lambda free light chains - huge increase in one month
Thank you for the quick replies!
At my recent appointment,
Kappa was 0.875 mg/dL (same as November)
Lambda was 15.208 (a jump from 5.25 in November)
Ratio was 0.05 (0.13 in November)
All of my other tests were relatively normal, besides a slight increase in my IgA (and interestingly enough, my IgG has returned to normal for the first time in 2 years.) Hoping the biopsy comes back negative (scheduled for March 12).
At my recent appointment,
Kappa was 0.875 mg/dL (same as November)
Lambda was 15.208 (a jump from 5.25 in November)
Ratio was 0.05 (0.13 in November)
All of my other tests were relatively normal, besides a slight increase in my IgA (and interestingly enough, my IgG has returned to normal for the first time in 2 years.) Hoping the biopsy comes back negative (scheduled for March 12).
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PattiM - Name: Patti
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 47
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