[kerrirunnergirl]

Kappa free light chains elevated - is remission over?

by kerrirunnergirl on Thu Dec 17, 2015 8:52 am

Hi there

Went to oncologist appointment and received lab results. Trying not to freak out but we were not expecting these results.

Finished 6 rounds of Revlimid, Velcade, and dex in September. Went to complete response (CR). On maintenance Revlimid 10 mg everyday.

Husband has light chain myeloma. Light chains have been normal since 2nd round of treatment.

Kappa light chains went up to 2.21 mg/dl (normal range is 0.33-1.94).

Four weeks ago, kappa light chains were 0.43.

Trying not to freak out..

Oncologist suggested waiting 6 weeks then rechecking results and doing CT to check for new lesions.

All other blood work normal..

Just wondering if this fluctuation can be normal or if he possibly is coming out of remission..

ugh

Thank you for input and have a Merry Christmas kerri

[Ron Harvot]

Re: Kappa free light chains elevated - is remission over?

by Ron Harvot on Thu Dec 17, 2015 1:16 pm

Kerri,

Don't freak out. A single test does not make a trend. The test results were barely over the norm. The test may be an anomaly; you need a few to determine if there is a trend. Also, you did not say if the FLC ratio (kappa / lambda ratio) was within range or not.

If the kappa numbers over a period of time were consistently climbing and going over 100, then that would be different. However, I would not be alarmed about a 2.21 single test.

[K_Shash]

Re: Kappa free light chains elevated - is remission over?

by K_Shash on Thu Dec 17, 2015 7:54 pm

Hello Kerri,

It seems that I am in a similar situation and the following is a summary of my 'journey' below.

Background:
I had eight cycles of the RVD treatment before my Oncologist started 'tapering' down my Chemo. The Velcade shots were dropped in early August and the Dex stopped only about 8 weeks ago. I had a nasty rash on both my legs within 10 days of stopping Dex. Therefore, my Oncologist dropped my Revlimid to the Maintenance level (15 mg every other day). No more rash!
I never achieved the single digit (on the 3.3-19.4 mg/L scale) Kappa reading and my readings were around 12.5 before the Dex was stopped and the Revlimid reduced by almost a half. The latest result was around 19.7 Kappa (a 50% jump from the prior 12.6) but the K/L ratio 1.56 (above the prior 1.04), within the 'normal range'. My blood tests are repeated every 4 weeks. I think I was reaching the end of my tolerance for the weekly Dex and I do not have the week long feeling of exhaustion anymore. I did have two occasions of minor rash on my arms toward the end of the '3 weeks on' of Revlimid. But the latest episode of the rash was within 10 days and pretty severe.

Flu and other infections:
I started my treatment in mid-December 2014 (my Kappa was at about 1,070) and I was responding very well till I had a week long Flu and my Kappa reading doubled (instead of dropping by 30% or 40%) and it took 2 more cycles before it came back to the pre-Flu level. Also, the only account I could find about the effects of a flu shot on the Kappa reading, it is reported that one would expect at least a 25% increase in the Kappa. That is with the milder, 'dead virus' vaccine. I had my Flu shot about 3 weeks ago and I will find out the Blood Test (scheduled for 12/21) results on the 23rd.

My Oncologist essentially told me what Ron Harvot has written. However, these Blood Test results.. data points are 4 weeks apart in my case and it seems to take for ever to get any meaningful trend over just a few weeks.

I'll be posting my Kappa and K/L next week (in my thread Induction to Maintenance, a Transition) and wish you all the best with the next test and with the CT scan.