Is there a way to find actual % of multiple myeloma cells in the body when a Bone Marrow Apirate and Thephine Biopsy was done but shows FOCAL disease (very unreliable , you always get a different reading)
serum FLC shows (after 7 cycles of CTD)
kappa ( mg / L ) 2882 {3.30-19.40}
lambda ( mg / L ) 7.7 {5.71-26.30}
kappa/lambda Ratio 374.286 {0.260-1.650}
The disease is LCMM (light chain - kappa , myeloma)
Oncologist said the sFLC is not ``myeloma count`` , it`s just a marker
in this case is the ``kappa`` reading the m-protein ?
I thought for light chains myeloma only , the test is done in urine , this is serum.
There is Free Lite test for Urine multiple myeloma only , done in blood.
In this case is it an accurate measurement to test for LC in blood but not urine ?
when a lot of this protein is going out through urine
Any comments are appreciated.
thank you.
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johanna - Name: Joanna
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: august 2012
- Age at diagnosis: 60
Re: Percent myeloma cells when marrow aspirate is focal
Hi Johanna, Our blood has antibodies, that are normally there. They are composed of 'heavy' and 'light' protein chains. Even normally, there are some extra 'light' chains floating in our blood. They are labelled as 'kappa' and 'lambda' and a ratio can be made of their amounts. As you noted the normal ratio is about 0.26-1.65.
If the monoclonal proteins seen in myeloma are present in the blood, the large quantities of them change the normal ratio. For example, if the mononclonal antibodies are producing large amounts of 'kappa' protein, then the ratio becomes larger than the normal. So yes, the 'kappa' relates to the 'M' protein.
You can download or have mailed to you a whole series of booklets from the Int'l Myeloma Fdn. (IMF) on topics related to myeloma. They have a publication called 'Serum Free Light Chain Tests'.
The Serum Free Light Chain tests (FLC) are very sensitive and a good marker of the myeloma.
Hope that helps!
If the monoclonal proteins seen in myeloma are present in the blood, the large quantities of them change the normal ratio. For example, if the mononclonal antibodies are producing large amounts of 'kappa' protein, then the ratio becomes larger than the normal. So yes, the 'kappa' relates to the 'M' protein.
You can download or have mailed to you a whole series of booklets from the Int'l Myeloma Fdn. (IMF) on topics related to myeloma. They have a publication called 'Serum Free Light Chain Tests'.
The Serum Free Light Chain tests (FLC) are very sensitive and a good marker of the myeloma.
Hope that helps!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Percent myeloma cells when marrow aspirate is focal
Hello Johanna,
There is no perfect way to correct for focal deposits of myeloma. Our pathologists see alot of myeloma and do have various ways that they try to correct for this finding but it is still somewhat of a guess.
It looks like this patient has active myeloma with such a high free light chain ratio and very elevted free kappa light chain level.
Although free light chains can be measured in the urine using the FREELIGHT assay it is not recommended because there has been very little research on this application and therefore the results cannot be interpreted. Bence Jones proteins ( similar to free light chains) can be measured in the urine and used to follow the disease course for some patients with myeloma. The use of the FREELIGHT chain assay should be restricted to blood only.
There is no perfect way to correct for focal deposits of myeloma. Our pathologists see alot of myeloma and do have various ways that they try to correct for this finding but it is still somewhat of a guess.
It looks like this patient has active myeloma with such a high free light chain ratio and very elevted free kappa light chain level.
Although free light chains can be measured in the urine using the FREELIGHT assay it is not recommended because there has been very little research on this application and therefore the results cannot be interpreted. Bence Jones proteins ( similar to free light chains) can be measured in the urine and used to follow the disease course for some patients with myeloma. The use of the FREELIGHT chain assay should be restricted to blood only.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Percent myeloma cells when marrow aspirate is focal
Dr. Libby , thank you for the reply.
we read all the time about LCMM and still get a bit fuzzy at times trying to understand.
the hematology dep. takes BLOOD 1 / month and does Serum FLC test , urine is taken very ocasionally by renal department. i assume they do UPEP / 24 H or something similar. we haven`t got the results yet, to see what tests they do.
my concern is that they refused to stage disease and give % of M cells saying that multiple myeloma is focal and can`t do a proper count for myeloma cells and tumor burden
maybe a second oppinion would be something worthwhile to consider in the near future
thank you again Dr. Libby ,
kind regards.. Johanna
we read all the time about LCMM and still get a bit fuzzy at times trying to understand.
the hematology dep. takes BLOOD 1 / month and does Serum FLC test , urine is taken very ocasionally by renal department. i assume they do UPEP / 24 H or something similar. we haven`t got the results yet, to see what tests they do.
my concern is that they refused to stage disease and give % of M cells saying that multiple myeloma is focal and can`t do a proper count for myeloma cells and tumor burden
maybe a second oppinion would be something worthwhile to consider in the near future
thank you again Dr. Libby ,
kind regards.. Johanna
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johanna - Name: Joanna
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: august 2012
- Age at diagnosis: 60
4 posts
• Page 1 of 1