Free Kappa LC Free Lambda LC K/L Ratio
Last Month 4.46 6.64 .67
This Month 5.08 3.30 1.54
Background: IGA Kappa myeloma (sCR after CyBorD + Rev Maint.)
Question: Is the drop in free lambda lc or any other variance in these numbers a concern?
Forums
5 posts
• Page 1 of 1
Re: Free Lambda Light Chain Variance
I have the same question. Having a non secretory myeloma , free ligth ratio is one of the few indicators to' monitor the desease so it' s very important any early indication.
Is a decreasing trend over the months , even if in the allowed range ,an early indicator of the relapsed desease?
Is a decreasing trend over the months , even if in the allowed range ,an early indicator of the relapsed desease?
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Carla63 - Age at diagnosis: 46
Re: Free Lambda Light Chain Variance
The serum free light chain assay has become an important test in the diagnosis and subsequent monitoring of multiple myeloma patient disease status. This is especially important in patients with what was previously referred to as nonsecretory myeloma. As both of you had posted, we can now follow patient's with a little secretary disease. In the past these patients are much more difficult to monitor without invasive techniques.
Without knowing either the history completely, it is difficult to make any conclusive statements. However, I can state that monitoring of serum free light chain ratios- which is the most appropriate way to utilizes this tool-8 is still not perfect. Simple changes in serum free light chain ratio or levels are sensitive to a number of things including renal function, daily variance in labs, or testing centers. That being said, one needs to monitor your counts carefully. The trends over time will be the best barometer of disease status.
Without knowing either the history completely, it is difficult to make any conclusive statements. However, I can state that monitoring of serum free light chain ratios- which is the most appropriate way to utilizes this tool-8 is still not perfect. Simple changes in serum free light chain ratio or levels are sensitive to a number of things including renal function, daily variance in labs, or testing centers. That being said, one needs to monitor your counts carefully. The trends over time will be the best barometer of disease status.
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Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
Re: Free Lambda Light Chain Variance
Thanks Dr. Shain for your reply.
I have been told that different testing centers shoudn't influence the result being the kit a commercial one , the same in every institutes in the world.
I have some doubts having experienced personally different results , last year I have done it at DFCI In Boston for a second opinion , ratio was below the range and the week after in Italy in the contest of my routine contro, result was perfectly in the range even if decreased with respect to' the previous one done in the same test center. After some week s , free of any therapy, the result of MRI and biopsy started to' show a relapsed deasease. Also the next free ligth ratio was worsten always in the range.
Now I'm at third cycle of VDT-PACE and free ligth ratio starts slowly to' increase always in the range.
Now any variance even if minor in the free ligth ratio is worrying me a lot and I don't know Who and what believes.
I have been told that different testing centers shoudn't influence the result being the kit a commercial one , the same in every institutes in the world.
I have some doubts having experienced personally different results , last year I have done it at DFCI In Boston for a second opinion , ratio was below the range and the week after in Italy in the contest of my routine contro, result was perfectly in the range even if decreased with respect to' the previous one done in the same test center. After some week s , free of any therapy, the result of MRI and biopsy started to' show a relapsed deasease. Also the next free ligth ratio was worsten always in the range.
Now I'm at third cycle of VDT-PACE and free ligth ratio starts slowly to' increase always in the range.
Now any variance even if minor in the free ligth ratio is worrying me a lot and I don't know Who and what believes.
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Carla63 - Age at diagnosis: 46
Re: Free Lambda Light Chain Variance
In myeloma, especially with low levels of disease, variances can be seen even within the same institution- the test itself has variance. This is one of the reasons there is a range per test.
For your case specifically, it is important to continue to monitor and watch the trends over time (months/cycles). Further, one must take in to account all of the factors; SFLC are a single mode of following disease. So, I would try to patient and continue to monitor closely taking in to account the other modes of monitoring disease, when appropriate.
Please remember one of the most important aspects of therapy in myeloma is to control the disease and remain positive.
For your case specifically, it is important to continue to monitor and watch the trends over time (months/cycles). Further, one must take in to account all of the factors; SFLC are a single mode of following disease. So, I would try to patient and continue to monitor closely taking in to account the other modes of monitoring disease, when appropriate.
Please remember one of the most important aspects of therapy in myeloma is to control the disease and remain positive.
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Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
5 posts
• Page 1 of 1