Hi everyone,
I was diagnosed with smoldering multiple myeloma last month, and the doc tells me my numbers are all relatively good (and from what I have read, it seems he is correct). But I want to educate myself so I understand what is happening. To that end, I am trying to figure out the whole kappa-lambda free light chain ratio thing.
My results show:
Kappa light chain of 18.44 (with a normal range of 3.3 to 19.4)
Lambda light chain of 83.33 (normal range of 5.71 to 26.3)
Free kappa-lambda ratio of 0.22 (normal range of 0.26 to 1.65)
Any assistance you can give in helping me understand this will be much appreciated.
Thank you in advance,
Paige
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Paige - Name: Paige
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 2016
- Age at diagnosis: 49
Re: Smoldering myeloma & free light chain results
Hello Paige,
Fred here,
For the first time, the doctor used the smoldering myeloma term today during my visit. Other visits were categorized with MGUS. Some of my readings below:
Free Kappa Light Chain = 14.85
Free Lambda Light Chain = 2.71 L
Free Kappa / Lambda Ratio = 5.48 H
IgG = 2126 H
M-Spike = 2.0 H
Are you starting to make any sense of your results?
Regards,
Fred
Fred here,
For the first time, the doctor used the smoldering myeloma term today during my visit. Other visits were categorized with MGUS. Some of my readings below:
Free Kappa Light Chain = 14.85
Free Lambda Light Chain = 2.71 L
Free Kappa / Lambda Ratio = 5.48 H
IgG = 2126 H
M-Spike = 2.0 H
Are you starting to make any sense of your results?
Regards,
Fred
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Fred_M - Name: Fred M
- Who do you know with myeloma?: self
- When were you/they diagnosed?: April 2016
- Age at diagnosis: 59
Re: Smoldering myeloma & free light chain results
Paige,
Welcome to the forum from a fellow smolderer.
First, you want to take your kappa-lambda free light chain (FLC) ratio and invert it. This is because most of the literature talks about the involved/uninvolved free light chain (FLC) ratio. Since your involved FLC happens to be your lambda FLC (the one that is reading high on your lab results), your FLC ratio is 1/0.22=4.5.
That's a very low ratio for somebody with a plasma cell disorder... which is good news. To put that number into perspective, some doctors start to consider treatment when that ratio hits 100 (although that is not a given).
However, your low FLC ratio number begs the question as to what your M-spike and bone marrow plasma cell percentage are? Which of those lab measurements bumped you from the MGUS category into into the smoldering category? I bet you are just on the edge of having a smoldering diagnosis given your low FLC ratio.
Lastly, you never want to focus on just one set of markers such as your FLC numbers. You really want to track your FLC numbers, M-spike, hemoglobin, creatinine and calcium levels to see if you might be progressing or developing any end-organ damage. It's also really helpful if you graph these numbers over time so that you can easily see if any of your numbers might be going south. This link will give you an idea of how I graph some of the markers that I track:
https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-60.html#p46149
Good luck and let us know if you have any questions.
Welcome to the forum from a fellow smolderer.
First, you want to take your kappa-lambda free light chain (FLC) ratio and invert it. This is because most of the literature talks about the involved/uninvolved free light chain (FLC) ratio. Since your involved FLC happens to be your lambda FLC (the one that is reading high on your lab results), your FLC ratio is 1/0.22=4.5.
That's a very low ratio for somebody with a plasma cell disorder... which is good news. To put that number into perspective, some doctors start to consider treatment when that ratio hits 100 (although that is not a given).
However, your low FLC ratio number begs the question as to what your M-spike and bone marrow plasma cell percentage are? Which of those lab measurements bumped you from the MGUS category into into the smoldering category? I bet you are just on the edge of having a smoldering diagnosis given your low FLC ratio.
Lastly, you never want to focus on just one set of markers such as your FLC numbers. You really want to track your FLC numbers, M-spike, hemoglobin, creatinine and calcium levels to see if you might be progressing or developing any end-organ damage. It's also really helpful if you graph these numbers over time so that you can easily see if any of your numbers might be going south. This link will give you an idea of how I graph some of the markers that I track:
https://myelomabeacon.org/forum/fenofibrate-tricor-and-multiple-myeloma-t2690-60.html#p46149
Good luck and let us know if you have any questions.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Smoldering myeloma & free light chain results
Hi Fred and Multibilly,
Thank you for your replies,
Yes, the numbers are starting to make sense and yes, I am oh so barely smoldering – the one time it's good to be an underachiever!
My M-spike is 1 and my plasma cells are 10%. Full skeletal X-ray showed no lesions at all, I am IgG with a normal IgA and a low IgM, creatinine is within normal range, calcium is a little on the low side (8.2 on a scale of 8.5-10.1), Hemoglobin is barely within normal (12.1 on a scale of 12.0-16.0).
I have started a graph so I can track things, but I am still learning what everything is and what everything means. I go back to the hem/onc in early December and then to a multiple myeloma specialist at MD Anderson in early January so after the next round or two of test results, things should start making more sense to me (I hope).
Thank you again for your guidance,
Paige
Thank you for your replies,
Yes, the numbers are starting to make sense and yes, I am oh so barely smoldering – the one time it's good to be an underachiever!
My M-spike is 1 and my plasma cells are 10%. Full skeletal X-ray showed no lesions at all, I am IgG with a normal IgA and a low IgM, creatinine is within normal range, calcium is a little on the low side (8.2 on a scale of 8.5-10.1), Hemoglobin is barely within normal (12.1 on a scale of 12.0-16.0).
I have started a graph so I can track things, but I am still learning what everything is and what everything means. I go back to the hem/onc in early December and then to a multiple myeloma specialist at MD Anderson in early January so after the next round or two of test results, things should start making more sense to me (I hope).
Thank you again for your guidance,
Paige
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Paige - Name: Paige
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 2016
- Age at diagnosis: 49
Re: Smoldering myeloma & free light chain results
Hi Paige,
You may want to consider getting some basic anemia tests (serum iron, TIBC, ferritin, etc) and experiment in getting more iron into your diet to see if you can pull up your hemoglobin level up a bit.
My hemoglobin level hit 12.4 g/dL back in the summer of 2014 (12.6 g/dL - 17.7 g/dL is the normal range for the lab I use). Even though my iron, TIBC, ferritin, etc labs showed these numbers as being in range, a change in my diet has now pulled my hemoglobin level up to a very respectable 14.5 g/dL. I now eat red meat about once a week (no amount of iron-rich vegetables helped with my numbers) and I take an iron supplement. But before starting the iron supplement, I first checked with my onc to see that he was OK with it.
You may want to consider getting some basic anemia tests (serum iron, TIBC, ferritin, etc) and experiment in getting more iron into your diet to see if you can pull up your hemoglobin level up a bit.
My hemoglobin level hit 12.4 g/dL back in the summer of 2014 (12.6 g/dL - 17.7 g/dL is the normal range for the lab I use). Even though my iron, TIBC, ferritin, etc labs showed these numbers as being in range, a change in my diet has now pulled my hemoglobin level up to a very respectable 14.5 g/dL. I now eat red meat about once a week (no amount of iron-rich vegetables helped with my numbers) and I take an iron supplement. But before starting the iron supplement, I first checked with my onc to see that he was OK with it.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Smoldering myeloma & free light chain results
I think I will wait until I see the multiple myeloma specialist in January to ask about supplements.
I am curious Multibilly as to how you are so knowledgeable about all things multiple myeloma? I have read numerous of your posts and I am in awe of the depth and breadth of your multiple myeloma knowledge. Are you in healthcare or are you self-taught?
Thanks,
Paige
I am curious Multibilly as to how you are so knowledgeable about all things multiple myeloma? I have read numerous of your posts and I am in awe of the depth and breadth of your multiple myeloma knowledge. Are you in healthcare or are you self-taught?
Thanks,
Paige
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Paige - Name: Paige
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 2016
- Age at diagnosis: 49
Re: Smoldering myeloma & free light chain results
I'm not in the healthcare biz at all - I just read a lot and enjoy learning from others on this forum 
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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