So I know an answer regarding this isn't in concrete, but if my light chains are on the rise (about 8 points each month), but I do not have an m spike and every other category that was tested is within range, does that mean I am relapsing or is this considered an asymptomatic relapse?
I'm tired of worrying about these elevated numbers (kappa lambda number is around 94).
Forums
Re: Light chains rising (but no m-spike) - am I relapsing?
I just wanted to make sure I understood you correctly. So, both of your kappa and lambda light chains are on the rise? Are the k/l ratios in normal range? How are your kidney functions?
-
dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Light chains rising (but no m-spike) - am I relapsing?
Dear Guest,
You did not provide enough information for any of us to comment. You mentioned that your light chains were rising but you do not have an M spike.
I have light chain multiple myeloma and have never had an M spike.
When you are talking about light chains did you get the test called the Free Light Chain Assay?
It is a common test that is run expecially for patients like me, that do not have a measurable M spike using the SPEP test.
These are the normal ranges for the FLCA:
Kappa - 3.30-19.4
Lambda - 5.71-26.3
K/L ratio - .26-1.65
From what you indicated it does not sound like you had a Free Light Chain Assay test. I am not sure what a kappa lamda number of 94 is referencing. If it was intended to reference the ratio, then it is obviously way out of the norm as the max should be no more than 1.65. You may need to look at your tests closer and see what they are measuring.
Ron
You did not provide enough information for any of us to comment. You mentioned that your light chains were rising but you do not have an M spike.
I have light chain multiple myeloma and have never had an M spike.
When you are talking about light chains did you get the test called the Free Light Chain Assay?
It is a common test that is run expecially for patients like me, that do not have a measurable M spike using the SPEP test.
These are the normal ranges for the FLCA:
Kappa - 3.30-19.4
Lambda - 5.71-26.3
K/L ratio - .26-1.65
From what you indicated it does not sound like you had a Free Light Chain Assay test. I am not sure what a kappa lamda number of 94 is referencing. If it was intended to reference the ratio, then it is obviously way out of the norm as the max should be no more than 1.65. You may need to look at your tests closer and see what they are measuring.
Ron
-
Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Light chains rising (but no m-spike) - am I relapsing?
Here you go:
Comp. Metabolic Panel (14)
Glucose, Serum 91 mg/dL 65 − 99 01
BUN 13 mg/dL 6 − 20 01
Creatinine, Serum 0.93 mg/dL 0.76 − 1.27 01
eGFR If NonAfricn Am 106 mL/min/1.73 >59
eGFR If Africn Am 123 mL/min/1.73 >59
BUN/Creatinine Ratio 14 8 − 19
Sodium, Serum 139 mmol/L 134 − 144 01
Potassium, Serum 4.4 mmol/L 3.5 − 5.2 01
Chloride, Serum 100 mmol/L 97 − 108 01
Carbon Dioxide, Total 27 mmol/L 19 − 28 01
Calcium, Serum 9.9 mg/dL 8.7 − 10.2 01
Protein, Total, Serum 6.8 g/dL 6.0 − 8.5 01
Albumin, Serum 4.4 g/dL 3.5 − 5.5 01
Globulin, Total 2.4 g/dL 1.5 − 4.5
A/G Ratio 1.8 1.1 − 2.5
Bilirubin, Total 0.5 mg/dL 0.0 − 1.2 01
Alkaline Phosphatase, S 73 IU/L 39 − 117 01
AST (SGOT) 26 IU/L 0 − 40 01
ALT (SGPT) 36 IU/L 0 − 44 01
IFE+Protein Electro, 24−Hr Ur
Protein,Total,Urine 11.5 mg/dL 0.0 − 15.0 01
Prot,24hr calculated 138.0 mg/24 hr 30.0 − 150.0
Albumin, U 8.8 % 01
Alpha−1−Globulin, U 1.4 % 01
Alpha−2−Globulin, U 7.1 % 01
Beta Globulin, U 75.7 % 01
Gamma Globulin, U 7.0 % 01
M−Spike, % Present % Not Observed 01
Immunofixation shows IgA monoclonal protein with kappa light chains
Immunofixation Result, Urine
specificity and monoclonal free kappa light chains (Bence−Jones Protein).
Protein Elec + Interp, Serum
Albumin 4.4 g/dL 3.2 − 5.6 01
Alpha−1−Globulin 0.2 g/dL 0.1 − 0.4 01
Alpha−2−Globulin 0.6 g/dL 0.4 − 1.2 01
Beta Globulin 1.0 g/dL 0.6 − 1.3 01
Gamma Globulin 0.6 g/dL 0.5 − 1.6 01
M−Spike Not Observed g/dL Not Observed 01
Globulin, Total 2.4 g/dL 2.0 − 4.5
A/G Ratio 1.8 0.7 − 2.0
Please note: 01
Protein electrophoresis scan will follow via computer, mail, or courier delivery.
The SPE pattern appears essentially unremarkable. Evidence of P E Interpretation, S monoclonal protein is not apparent.
Immunofixation, Serum
Comment: 01
Immunofixation Result, Serum
FAINT BANDS NOTED IN IGA AND LAMBDA. SUGGEST RETESTING IN 4−6
MONTHS IF CLINICALLY INDICATED.
Immunoglobulin G, Qn, Serum 668 Low mg/dL 700 − 1600 01
Immunoglobulin A, Qn, Serum 105 mg/dL 91 − 414 01
Immunoglobulin M, Qn, Serum 45 mg/dL 40 − 230 01
Creatinine Clearance
Creatinine, Urine 107.8 mg/dL 24.0 − 392.0 01
Creatinine, Ur 24hr 1293.6 mg/24 hr 1000.0 − 2000.0
Creatinine Clearance 97 mL/min 97 − 137
The above range is based on 1.73 square meter average body surface area.
Free K+L Lt Chains,Qn,S
Free Kappa Lt Chains,S 94.14 High mg/L 3.30 − 19.40 01
Free Lambda Lt Chains,S 5.53 Low mg/L 5.71 − 26.30 01
Kappa/Lambda Ratio,S 17.02 High 0.26 − 1.65
LDH 159 IU/L 0 − 225 01
Comp. Metabolic Panel (14)
Glucose, Serum 91 mg/dL 65 − 99 01
BUN 13 mg/dL 6 − 20 01
Creatinine, Serum 0.93 mg/dL 0.76 − 1.27 01
eGFR If NonAfricn Am 106 mL/min/1.73 >59
eGFR If Africn Am 123 mL/min/1.73 >59
BUN/Creatinine Ratio 14 8 − 19
Sodium, Serum 139 mmol/L 134 − 144 01
Potassium, Serum 4.4 mmol/L 3.5 − 5.2 01
Chloride, Serum 100 mmol/L 97 − 108 01
Carbon Dioxide, Total 27 mmol/L 19 − 28 01
Calcium, Serum 9.9 mg/dL 8.7 − 10.2 01
Protein, Total, Serum 6.8 g/dL 6.0 − 8.5 01
Albumin, Serum 4.4 g/dL 3.5 − 5.5 01
Globulin, Total 2.4 g/dL 1.5 − 4.5
A/G Ratio 1.8 1.1 − 2.5
Bilirubin, Total 0.5 mg/dL 0.0 − 1.2 01
Alkaline Phosphatase, S 73 IU/L 39 − 117 01
AST (SGOT) 26 IU/L 0 − 40 01
ALT (SGPT) 36 IU/L 0 − 44 01
IFE+Protein Electro, 24−Hr Ur
Protein,Total,Urine 11.5 mg/dL 0.0 − 15.0 01
Prot,24hr calculated 138.0 mg/24 hr 30.0 − 150.0
Albumin, U 8.8 % 01
Alpha−1−Globulin, U 1.4 % 01
Alpha−2−Globulin, U 7.1 % 01
Beta Globulin, U 75.7 % 01
Gamma Globulin, U 7.0 % 01
M−Spike, % Present % Not Observed 01
Immunofixation shows IgA monoclonal protein with kappa light chains
Immunofixation Result, Urine
specificity and monoclonal free kappa light chains (Bence−Jones Protein).
Protein Elec + Interp, Serum
Albumin 4.4 g/dL 3.2 − 5.6 01
Alpha−1−Globulin 0.2 g/dL 0.1 − 0.4 01
Alpha−2−Globulin 0.6 g/dL 0.4 − 1.2 01
Beta Globulin 1.0 g/dL 0.6 − 1.3 01
Gamma Globulin 0.6 g/dL 0.5 − 1.6 01
M−Spike Not Observed g/dL Not Observed 01
Globulin, Total 2.4 g/dL 2.0 − 4.5
A/G Ratio 1.8 0.7 − 2.0
Please note: 01
Protein electrophoresis scan will follow via computer, mail, or courier delivery.
The SPE pattern appears essentially unremarkable. Evidence of P E Interpretation, S monoclonal protein is not apparent.
Immunofixation, Serum
Comment: 01
Immunofixation Result, Serum
FAINT BANDS NOTED IN IGA AND LAMBDA. SUGGEST RETESTING IN 4−6
MONTHS IF CLINICALLY INDICATED.
Immunoglobulin G, Qn, Serum 668 Low mg/dL 700 − 1600 01
Immunoglobulin A, Qn, Serum 105 mg/dL 91 − 414 01
Immunoglobulin M, Qn, Serum 45 mg/dL 40 − 230 01
Creatinine Clearance
Creatinine, Urine 107.8 mg/dL 24.0 − 392.0 01
Creatinine, Ur 24hr 1293.6 mg/24 hr 1000.0 − 2000.0
Creatinine Clearance 97 mL/min 97 − 137
The above range is based on 1.73 square meter average body surface area.
Free K+L Lt Chains,Qn,S
Free Kappa Lt Chains,S 94.14 High mg/L 3.30 − 19.40 01
Free Lambda Lt Chains,S 5.53 Low mg/L 5.71 − 26.30 01
Kappa/Lambda Ratio,S 17.02 High 0.26 − 1.65
LDH 159 IU/L 0 − 225 01
-
Guest1
Re: Light chains rising (but no m-spike) - am I relapsing?
It does appear that your serum kappa light chain numbers are up, although IgA itself is still well within range. When do you see your doctor? When is the next test?
-
dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Light chains rising (but no m-spike) - am I relapsing?
It seems to me that with the exception of the kappa, everything else looks to be in normal range. Nevertheless, I would definitely contact your doctor and ask them what's to be done, if there is anything to do.
As to whether you are relapsing, I am definitely not able to answer that question. I can only say that given that there is an anomaly in one of the numbers, I would get in contact with the doc and talk to him/her.
My mom's myeloma specialist is extremely communicative, and answers emails within a matter of hours, if not minutes.
As to whether you are relapsing, I am definitely not able to answer that question. I can only say that given that there is an anomaly in one of the numbers, I would get in contact with the doc and talk to him/her.
My mom's myeloma specialist is extremely communicative, and answers emails within a matter of hours, if not minutes.
-
dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Light chains rising (but no m-spike) - am I relapsing?
You are showing signs of IgA kappa light chain multiple myeloma as your kappa chain is high and lambda low with a high ratio but no measurable M spike but traces of Bence Jones protein.
The next question is whether or not you have any of the C.R.A.B. symptoms. From your tests this is what I see.
C - Calcium levels elevated - No the tests are in the normal range
R - Renal Impairment - No appears creatinine levels and BUN and C/B levels are ok
A - Anemia - Your have disclosed a full chemistry panel etc but did not show the CBC which would show your red counts, hemoglobin and hematocrit. I will assume they are normal
B - Bone lesions - Did you have a bone scan?
My conclusion is from what I see so far it indicates that you may have asymptomatic light chain IgA kappa multiple myeloma and it could be considered smoldering multiple myeloma if you are not anemic and have no bone lesions. However, since the light chains are rising, as you have indicated, then you will likely be starting treatment soon.
Let us know what the doctor tells you with your next checkup.
Ron
The next question is whether or not you have any of the C.R.A.B. symptoms. From your tests this is what I see.
C - Calcium levels elevated - No the tests are in the normal range
R - Renal Impairment - No appears creatinine levels and BUN and C/B levels are ok
A - Anemia - Your have disclosed a full chemistry panel etc but did not show the CBC which would show your red counts, hemoglobin and hematocrit. I will assume they are normal
B - Bone lesions - Did you have a bone scan?
My conclusion is from what I see so far it indicates that you may have asymptomatic light chain IgA kappa multiple myeloma and it could be considered smoldering multiple myeloma if you are not anemic and have no bone lesions. However, since the light chains are rising, as you have indicated, then you will likely be starting treatment soon.
Let us know what the doctor tells you with your next checkup.
Ron
-
Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Light chains rising (but no m-spike) - am I relapsing?
Hi Ron,
I don't think the tests would indicate that it's IgA kappa myeloma, since the IgA measurement is within normal range. The tests do indicate a rise in kappa light chains only, though.
I don't think the tests would indicate that it's IgA kappa myeloma, since the IgA measurement is within normal range. The tests do indicate a rise in kappa light chains only, though.
-
dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Light chains rising (but no m-spike) - am I relapsing?
I'm in much the same boat, only my increase is Lambda,165, and my oncologist isn't concerned at this point, Dec.'13. I see him again in a couple of weeks and I'll know more then. I think that it takes some time to see if there is a trend. This is higher than I've been in the past, but I have had some spikes. They are seeing the M protein again but it is too small to quantify.
My take on it is that relapse is expected, but not welcomed. We do have distinct advantages however. We are being monitored for the disease, no surprises, and there are more advances being made and seemingly almost faster than the disease escalates.
My take on it is that relapse is expected, but not welcomed. We do have distinct advantages however. We are being monitored for the disease, no surprises, and there are more advances being made and seemingly almost faster than the disease escalates.
-
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
17 posts
• Page 1 of 2 • 1, 2