Hello everybody,
I am about 3 years in remission. Since I achieved the remission, the serum free light chains were normalized. Suddenly previous week my serum free light chain test results were abnormal and the doctor told me to repeat this week and again came back abnormal.
I have an IgG kappa myeloma, the kappa serum free light chain is in normal range 14.4 (3.3-19.4), but the lambda is under normal range 4.6 (5.71-26.3), making a ratio of 3.1.
Could that mean that the disease is relapsing? All other serum tests are normal. Thanks.
Take care everybody,
Niki
Forums
Re: High kappa-lambda ratio due to low lambda level
Are you taking any maintenance meds? Those can affect free light chain levels. Your abnormal ratio is the result of one of the light chains being lower than normal, not an elevation of one of them. From what I understand this is a different scenario from a light chain elevation. I have been in remission about 17 months since my stem cell transplant, and there have been a couple of occasions when my light chain ratio was slightly off due to one of the light chains being lower than normal. However, they came back into a normal ratio later on. I don't necessarily think this is an indicator of relapse; light chains can fluctuate.
What does you onc have to say about it?
If all of your other labs are normal, I would try not to anticipate the worst case scenario, especially if you are on maintenance meds.
I hope this proves to be a meaningless finding. Please keep us updated.
What does you onc have to say about it?
If all of your other labs are normal, I would try not to anticipate the worst case scenario, especially if you are on maintenance meds.
I hope this proves to be a meaningless finding. Please keep us updated.
Re: High kappa-lambda ratio due to low lambda level
Thank you very much for you response. I am on maintenance with Velcade, Revlimid, and dexamethasone (VRD). My oncologist told me just to wait and repeat the test in about a month. He says that it is unlikely to be a relapse but we must wait. I wish you a long lasting remission. Take care
Re: High kappa-lambda ratio due to low lambda level
Hi Niki:
The fact that they track the kappa-lambda ratio does get tricky if one of the numbers gets very low (this is an issue that we have discussed with our doctor). It's just grammar school math. If the lower number (the denominator) is low, the ratio gets high. RVD also can suppress the kappa or the lambda.
If your myeloma is M-Spike dominated, and you did not have a high level of light chains, then either the kappa or the lambda, or both will be suppressed, throwing the ratio out of whack. That would not be a problem.
If both of the numbers were above normal (say by a little bit), and the ratio starting trending out of bounds over time, that would be more of a concern.
Good luck
The fact that they track the kappa-lambda ratio does get tricky if one of the numbers gets very low (this is an issue that we have discussed with our doctor). It's just grammar school math. If the lower number (the denominator) is low, the ratio gets high. RVD also can suppress the kappa or the lambda.
If your myeloma is M-Spike dominated, and you did not have a high level of light chains, then either the kappa or the lambda, or both will be suppressed, throwing the ratio out of whack. That would not be a problem.
If both of the numbers were above normal (say by a little bit), and the ratio starting trending out of bounds over time, that would be more of a concern.
Good luck
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JPC - Name: JPC
Re: High kappa-lambda ratio due to low lambda level
The combo of a normal kappa + low lambda + high FLC ratio can also possibly suggest the presence of bone marrow suppression (myelosuppression) https://en.wikipedia.org/wiki/Bone_marrow_suppression
Myelosuppression can be caused by the maintenance drugs you are taking (specifically the Revlimid).
Myelosuppression can be caused by the maintenance drugs you are taking (specifically the Revlimid).
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High kappa-lambda ratio due to low lambda level
Thank you very much for you responses and your help. Let's hope for the best. This disease is very complicated for an average person to understand what's going on. Best regards and take care
Re: High kappa-lambda ratio due to low lambda level
Dear all:
Since yesterday I am reading about FLC. I am IgG kappa multiple myeloma.
My hematologist does not seem to be as concerned about FLC as he is about the M-spike.
Yesterday I read several published papers that indicate FLC could be influenced by autoimmune diseases, rheumatoid arthritis, inflammation, etc.
Thank you.
Since yesterday I am reading about FLC. I am IgG kappa multiple myeloma.
My hematologist does not seem to be as concerned about FLC as he is about the M-spike.
Yesterday I read several published papers that indicate FLC could be influenced by autoimmune diseases, rheumatoid arthritis, inflammation, etc.
Thank you.
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MMFeb16,15 - Who do you know with myeloma?: Self
- When were you/they diagnosed?: February 16, 2015
- Age at diagnosis: 66
Re: High kappa-lambda ratio due to low lambda level
I agree. The free light chain results can fluctuate for various reasons.
Today I received the serum immunofixation results, which was done the same day as the sFLC test. It came back abnormal too; positive for kappa, while I was diagnosed for an IgG kappa. It is different from the original clone, so I really don't know what it means.
Today I received the serum immunofixation results, which was done the same day as the sFLC test. It came back abnormal too; positive for kappa, while I was diagnosed for an IgG kappa. It is different from the original clone, so I really don't know what it means.
Re: High kappa-lambda ratio due to low lambda level
Hi Niki,
I'm a bit confused by your latest post in this thread.
You were originally diagnosed with IgG-kappa type multiple myeloma.
But now your serum immunofixation test simply states "kappa" and not IgG-kappa or IgA-kappa or some other variation? (I'm assuming that the immunofixation test was a blood/serum test).
I'm just trying to understand exactly what kind of clone your multiple myeloma has changed to.
Also, do you currently have a serum M-spike?
I'm a bit confused by your latest post in this thread.
You were originally diagnosed with IgG-kappa type multiple myeloma.
But now your serum immunofixation test simply states "kappa" and not IgG-kappa or IgA-kappa or some other variation? (I'm assuming that the immunofixation test was a blood/serum test).
I'm just trying to understand exactly what kind of clone your multiple myeloma has changed to.
Also, do you currently have a serum M-spike?
Last edited by Multibilly on Tue Mar 29, 2016 9:07 am, edited 1 time in total.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High kappa-lambda ratio due to low lambda level
Initially I was diagnosed with an IgG kappa type of myeloma. Now the immunofixation shows only kappa. The oncologist doesn't know still if this is a sign of relapse or just an immune reaction due to the fact that the clone is not the same as the original one and because the kappa light chain is in the normal range. 
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