Hi Cslatosch,
Welcome to the forum. I'm glad you reached out to this place.
The whole free light chain ratio is confusing to folks when they are first starting to deal with this disease.
I'm going to assume that these free light chain values are from a blood test and not a urine test, right?
On lab results, the free light chain ratio is typically expressed as kappa / lambda, which in your case is 7.6 / 58.5 = 0.13.
I can see from your posting that you have "IgA lambda" type multiple myeloma, because both your IgA and lambda values are elevated (and your report says this).
Alternatively, folks will often say that you have IgA immunogloblin and lambda free light chain "involvement". The flip side of this is that all your other immunoglobulins (IgG, IgM, etc) and your other free light chain (kappa) are "uninvolved".
When you hear about free light chain ratios, they are often expressed as the involved / uninvolved free light chain ratio, which in your case is the inverse of what was on your lab result since you have lambda free light chain "involvement".
In other words, your involved / uninvolved (lambda/kappa) free light chain ratio is:
58.5 / 7.6 = 7.7.
The normal serum free light chain ratio is 0.26-1.65, but a ratio of 7.7 is still considered to be pretty darn low. I honestly have no idea what to make of the numbers in your statement "For the first time today I heard the doctor say normal range is 23 and I am 53?"
You can read up more on free light chains
here.
The other thing is that you will almost always hear an M-spike expressed as an absolute value, rather than as a percentage. Are you sure that your Mprotein was reported as 1.3 mg/dL and not 1.3 g/dL? I'm going to guess that this was a typo.
Assuming it was a typo, your latest M-spike is 1.3 g/dL (an M-spike is the same thing as "Mprotein"), which is also a pretty low figure.
Lastly, I think you might be confusing percentages with the absolute values when you said "My M-spike was 1% with 2nd spike 0.50% and now I am at 1.3% for M-spike". Your M-spikes were likely 1.0 g/dL, 0.5 g/dL and 1.3 g/dL, respectively.
Hope this helps!
