[avrid]

negative bone marrow biopsy and high kappa light chain

by avrid on Fri Aug 24, 2012 11:50 pm

My wife is being investigated for Multiple Myeloma. She is 36. It all started with investigation into lower back pain. MRI showed that bones have mass lesions suggestive of metastatic disease. After investigation, it was suggested that she may have multiple myeloma.

How ever other tests have been conflicting. Her PET showed medium-high activity on the afflicted bone. Immunoglobulins test returned normal. Blood tests were normal with high lymphocyte. Microglobulin was higher than normal range.

Kappa Light Chain were unusually high and ratio was in hundreds suggesting multiple myeloma but bone marrow biopsy was negative and results were normal.

Is it normal that multiple myeloma can have negative bone marrow biopsy result. Also does high kappa points to multiple myeloma or can it be due to any thing else?

[Dr. Peter Voorhees]

Re: negative bone marrow biopsy and high kappa light chain

by Dr. Peter Voorhees on Sat Aug 25, 2012 1:53 pm

Dear avrid,

If the serum free kappa light chain concentration is really high, myeloma would be the most likely diagnosis. We have patients who have multiple lesions throughout their skeleton without diffuse marrow involvement. In those cases, the diagnosis is made by a directed biopsy of one of the lesions. The bone marrow test is deceivingly normal in these cases. I would suggest that as a next step. This will also tell you if it is something other than myeloma.

Best of luck!

Pete V.

[Anonymous]

Re: negative bone marrow biopsy and high kappa light chain

by Anonymous on Sun Aug 26, 2012 4:31 am

Hi Avrid..

My mother was initially diagnosed with myeloma with similar symptoms like your wife..

BMB - Negative
Number of Bone Lesions: 4
Beta -Microgloblin - 3300

She went 6 cycles of Revlimid 25mg and acheived Complete remission last Nov 2011.

Regards
Vijayabharathi C

[Marcia]

Re: negative bone marrow biopsy and high kappa light chain

by Marcia on Mon Aug 27, 2012 8:36 pm

Dear avrid,
Of course, Dr. Voorhees offers an excellent next step for diagnosis. I would add that if anyone in my family was in the same condition as your wife and only 36 years old, at this point in my myeloma experience, I would be requesting a second opinion with an experienced hematologist who has cared for many myeloma patients. I would also be looking for the closest myeloma specialist. If your wife has myeloma, she deserves nothing less. Her young age suggests a more aggressive form of the disease.

Good luck to the both of you. Be tough and stick together. I am so thankful for the support, the help with everyday errands, and physical presence of my husband during my long journey back to health.