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Light chains & paraproteinemia - always MGUS or myeloma?
Can someone tell me is lambda paraproteinaemia and light chains only related to MGUS and multiple myeloma or could it just be there for other reasons and can it go away?
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vix66 - Name: Vicki
- Who do you know with myeloma?: I have MGUS
- When were you/they diagnosed?: October 2015
- Age at diagnosis: 48
Re: Light chains & paraproteinemia - always MGUS or myeloma?
Hi Vix,
Having a monoclonal protein (paraproteinemia) on repeated lab tests is almost always a sign that someone has either MGUS or multiple myeloma. By its very nature, it means that there are monoclonal (mutated/abnormal/unhealthy) plasma cells producing monoclonal immunoglobulins, or paraproteins.
On the other hand, everyone has free light chains in their blood. People without MGUS or multiple myeloma also will often have both kappa and lambda free light chain levels that are above normal – for example, if they have an infection. What is unusual in healthy people, though, is for the ratio of the kappa and lambda free light chain levels to be outside the normal range. This is generally, but not always, a sign that there are monoclonal plasma cells producing excess levels of either monoclonal immunoglobulin and/or monoclonal free light chains of one particular type (lambda or kappa).
I hope this answers your question. Let us know, however, if you need further information or help on the topic.
Good luck!
Having a monoclonal protein (paraproteinemia) on repeated lab tests is almost always a sign that someone has either MGUS or multiple myeloma. By its very nature, it means that there are monoclonal (mutated/abnormal/unhealthy) plasma cells producing monoclonal immunoglobulins, or paraproteins.
On the other hand, everyone has free light chains in their blood. People without MGUS or multiple myeloma also will often have both kappa and lambda free light chain levels that are above normal – for example, if they have an infection. What is unusual in healthy people, though, is for the ratio of the kappa and lambda free light chain levels to be outside the normal range. This is generally, but not always, a sign that there are monoclonal plasma cells producing excess levels of either monoclonal immunoglobulin and/or monoclonal free light chains of one particular type (lambda or kappa).
I hope this answers your question. Let us know, however, if you need further information or help on the topic.
Good luck!
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JimNY
Re: Light chains & paraproteinemia - always MGUS or myeloma?
Hi Vicki,
As usual, Jim provided an excellent explanation. I would also add the following.
Paraproteinemia (monoclonal gammopathy) can be caused by a spectrum of plasma cell disorders including MGUS, smoldering multiple myeloma, multiple myeloma, amyloidosis, etc. But MGUS is the most common of these disorders and affects many people.
Also, these plasma cell disorders don't just "go away" on their own if multiple tests verify the presence of one of these disorders. But in the case of a diagnosis of MGUS, the disorder can remain stagnant and not develop into anything that you need to worry about. In fact, the chances of MGUS evolving into multiple myeloma is only about 1%/year. Most people with MGUS go through life without even knowing they have it and are never any the worse for it.
I would also stress Jim's comment that at least least MORE THAN ONE set of electrophoresis/immunofixation tests would need to be done to verify the presence of monoclonal proteins, especially given your very small M-spike (<0.2 g/dL). So if you have only had one set of these tests and your free light chain ratio is normal, your doc will very likely order a follow up set of immunofixation/electrophoresis tests (including a free light chain assay, quantified IgG/IgA/IgM immunoglobulins, etc) in the near future to make sure that the immunofixation/electrophoreis test that detected the paraproteinemia weren't simply a fluke.
I know that waiting for upcoming doctor visits and lab results can be really hard. Everyone on this forum deals with that angst. I would really encourage you not to think too much about this and just enjoy the weekend.
As usual, Jim provided an excellent explanation. I would also add the following.
Paraproteinemia (monoclonal gammopathy) can be caused by a spectrum of plasma cell disorders including MGUS, smoldering multiple myeloma, multiple myeloma, amyloidosis, etc. But MGUS is the most common of these disorders and affects many people.
Also, these plasma cell disorders don't just "go away" on their own if multiple tests verify the presence of one of these disorders. But in the case of a diagnosis of MGUS, the disorder can remain stagnant and not develop into anything that you need to worry about. In fact, the chances of MGUS evolving into multiple myeloma is only about 1%/year. Most people with MGUS go through life without even knowing they have it and are never any the worse for it.
I would also stress Jim's comment that at least least MORE THAN ONE set of electrophoresis/immunofixation tests would need to be done to verify the presence of monoclonal proteins, especially given your very small M-spike (<0.2 g/dL). So if you have only had one set of these tests and your free light chain ratio is normal, your doc will very likely order a follow up set of immunofixation/electrophoresis tests (including a free light chain assay, quantified IgG/IgA/IgM immunoglobulins, etc) in the near future to make sure that the immunofixation/electrophoreis test that detected the paraproteinemia weren't simply a fluke.
I know that waiting for upcoming doctor visits and lab results can be really hard. Everyone on this forum deals with that angst. I would really encourage you not to think too much about this and just enjoy the weekend.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Light chains & paraproteinemia - always MGUS or myeloma?
Thanks for the information, its very encouraging. I am so glad I found this site and some kind people that take the time to answer my questions, it is really appreciated 
It looks like I have had 3 tests that show the M-spike form different consultants over the past 8 months, only one has a result showing and that is of 2 gl. I keep finding more attachments to my medical record documents that show more results. In the UK we have only just been allowed to have access to our records in the past year. Before that we were only privy to what the doctors told us. My surgery is one of the first to allow this in my area. But as you say I will get more solid information when I see the haematologist on Wednesday hopefully.
Do many people get cold urticaria with MGUS and multiple myeloma?
many thanks
Vicki
It looks like I have had 3 tests that show the M-spike form different consultants over the past 8 months, only one has a result showing and that is of 2 gl. I keep finding more attachments to my medical record documents that show more results. In the UK we have only just been allowed to have access to our records in the past year. Before that we were only privy to what the doctors told us. My surgery is one of the first to allow this in my area. But as you say I will get more solid information when I see the haematologist on Wednesday hopefully.
Do many people get cold urticaria with MGUS and multiple myeloma?
many thanks
Vicki
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vix66 - Name: Vicki
- Who do you know with myeloma?: I have MGUS
- When were you/they diagnosed?: October 2015
- Age at diagnosis: 48
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