I am concerned about my husband's recent blood work which shows a low lambda free light chain (FLC) level and slightly high kappa/lambda free light chain ratio.
I will give history and the numbers.
Should I be concerned?
Of course, I will ask my doctor but while I wait to see him, I have to be doing research. The waiting is so hard.
History: My husband was diagnosed in May 2015 with IgA kappa multiple myeloma. He had induction therapy with Revlimid, Velcade, and dexamethasone, then an autologous stem cell transplant in October 2015. We waited to do maintenance as we were undecided. Started Revlimid maintenance in mid-April.
Below are his free light chain test results for the last 5 months. What I notice is the lambda free light chain level fluctuates. While kappa is still in the zone, it is steadily climbing.
What can I make from this? Thank you.
July, 2016
Kappa: 10.46
Lambda 5.33
Ratio: 1.96
April 29, 2016
Kappa: 10:31
Lambda: 7.99
Ratio: 1.29
March 25, 2016
Kappa: 5.78
Lambda: 4.16
Ratio: 1.30
March 4, 2016 (because this was such a jump, retested to see if anomaly on March 25)
Kappa: 42.74
Lambda: 8.73
Ratio: 4.90
February 2, 2016
Kappa: 4.22
Lambda: 8.68
Ratio: 0.49
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Re: Low lambda FLC level, high kappa-lambda ratio
I'm not a doc, but these latest free light chain results (low lambda + normal kappa + high ratio) could simply be a result of some mild bone marrow suppression that is being caused by the Revlimid. You would check for possible bone marrow suppression by going back and seeing if any of the blood counts on the CBC had dropped in tandem with the latest lab results.
In any case, these changes strike me as being fairly subtle and could partially be attributable to normal fluctuations in one's FLC levels.
In any case, these changes strike me as being fairly subtle and could partially be attributable to normal fluctuations in one's FLC levels.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Low lambda FLC level, high kappa-lambda ratio
Multibilly,
Have you thought about being a doctor?
I was able to email this info to my husband's docs, and while they did not give as much detailed thought as you, they weren't concerned.
Thank you!!! Unfortunately, paranoia sets in with myeloma.
Have you thought about being a doctor?
I was able to email this info to my husband's docs, and while they did not give as much detailed thought as you, they weren't concerned.
Thank you!!! Unfortunately, paranoia sets in with myeloma.
Re: Low lambda FLC level, high kappa-lambda ratio
Hi all,
Just recently had a transplant and am awaiting my 100-day bone marrow biopsy. In the meantime, I've just had a blood test. My paraprotein (M-spike) is still showing no trace, but I'm having trouble understanding my light chain results. Any tips would be great.
Kappa light chains: 10.10 (3.30-19.40)
Lambda light chains: 2.73 (5.71-26.30)
Kappa lambda ratio: 3.70 (0.26-1.65)
I've never got my head around these readings. My kappa level is in range, and the lambda level is low, but I'm concerned about the kappa-lambda ratio being high out of range. Any advice would be great. Not seeing my doctor to next week regarding the above, so thought I would make a head start and ask the Beacon.
Regards Dean
Just recently had a transplant and am awaiting my 100-day bone marrow biopsy. In the meantime, I've just had a blood test. My paraprotein (M-spike) is still showing no trace, but I'm having trouble understanding my light chain results. Any tips would be great.
Kappa light chains: 10.10 (3.30-19.40)
Lambda light chains: 2.73 (5.71-26.30)
Kappa lambda ratio: 3.70 (0.26-1.65)
I've never got my head around these readings. My kappa level is in range, and the lambda level is low, but I'm concerned about the kappa-lambda ratio being high out of range. Any advice would be great. Not seeing my doctor to next week regarding the above, so thought I would make a head start and ask the Beacon.
Regards Dean
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Dean UK - Name: Dean
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: April 2016
- Age at diagnosis: 41
Re: Low lambda FLC level, high kappa-lambda ratio
Normal kappa + low lambda + high ratio suggests bone marrow suppression. Many of the myeloma drugs can cause bone marrow suppression, as well as the high-dose chemo you received as part of your transplant process.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Low lambda FLC level, high kappa-lambda ratio
Thanks, Multibilly.
I definitely have some strange things going on with my bone marrow at present. 8 weeks after transplant now, bloods have been good and stable. Then today I was told that my immune system has dropped right back down again so I have be careful again regarding germs - a nightmare. Otherwise, all is good, but I thought this would have been sorted out by now. Maybe it's all connected with the light chains.
Regards and thanks again,
Dean
I definitely have some strange things going on with my bone marrow at present. 8 weeks after transplant now, bloods have been good and stable. Then today I was told that my immune system has dropped right back down again so I have be careful again regarding germs - a nightmare. Otherwise, all is good, but I thought this would have been sorted out by now. Maybe it's all connected with the light chains.
Regards and thanks again,
Dean
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Dean UK - Name: Dean
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: April 2016
- Age at diagnosis: 41
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