[carla]

Low kappa / lambda free light chain ratio

by carla on Mon Jul 14, 2014 9:01 am

I was diagnosed with multiple myeloma in September 2009. I'm currently on Revlimid after many chemotherapies, an auto stem cell transplant, and an allo transplant.

In the last blood work, my free light chain (Freelite) ratio is 0.42, coming from 0.80 in the previous month. Despite the value is still in the range (0.26 - 1.65), what is worrying me is that kappa is at 3 (range is 3.3 - 19.4 mg/L), less than minimum value, and lambda is at 7.

What does it mean that the values are so low? With those numbers of kappa and lambda free light chains, is the free light chain ratio still a valid indicator?

Kappa / lambda ratio is very important for me because I have a non secretory myeloma and so far the Freelite ratio has been very helpful in monitoring the disease.

Thanks

[dnalex]

Re: Low kappa / lambda free light chain ratio

by dnalex on Mon Jul 14, 2014 12:41 pm

Hello,

While the kappa serum levels are out of range on the low side, it doesn't seem to be that much out of range. I'm not a physician, and would not presume to make medical advice, but it seems to me that the numbers look OK. You might want to ask your doctor about it, though.

[Dr. Jonathan Kaufman]

Re: Low kappa / lambda free light chain ratio

by Dr. Jonathan Kaufman on Tue Jul 15, 2014 6:38 am

Carla,

In general, when I am reviewing these labs tests with my patients I focus on the involved light chain. A low kappa/lambda ratio could be a cause for concern for those patients with lambda light chain myeloma whose lambda increases. It is less worrisome when the ratio is low or decreasing when the sole abnormality is lowering of the uninvolved light chain. And if your light chain was kappa, then this wouldn't be anything to worry about at all.

I would re-check the serum free light chain in the next 1-2 months.

I wish you the best,

Jlk

[Carla]

Re: Low kappa / lambda free light chain ratio

by Carla on Thu Jul 17, 2014 11:59 pm

Thanks so much. At the diagnosis I was lambda then after the allo transplant is unclear. I'll repeat the test next month.