My doctor ordered a new blood test, and I just got some of the results back.
I am worried the free light chain kappa-lambda ratio (114.64) shows a progression to smoldering.
The doctor has ordered a new set of blood test as a result of yesterday's test, also have a bone marrow biopsy coming as well.
I was diagnosed with MGUS last August. My FISH results show I am a poor candidate for standard treatment due to chromosome deletions.
I have to say, I am wondering if I will be one of the few that progresses from MGUS to full blown multiple myeloma and at a pretty fast rate.
Thanks again, all of these test results are so confusing!
Kappa Free Light Chain 25.22 mg/dL (0.33-1.94)
Lambda Free Light Chain 0.22 mg/dL (0.57-2.63)
Lambda/Kappa ratio, free LC 0.01 (0.61-3.85)
K/L RATIO;FREE LC 114.64
IgG 2,677 mg/dL
IgA <20 mg/dL
IgM <13 mg/dL
B2M 2.6 mg/L
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penbed - Name: Jack D. Lovett
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: August 2017
- Age at diagnosis: 70
Re: Am I now smoldering rather than MGUS?
Hi Penbed,
Before you draw too many conclusions from these most recent blood tests, perhaps you can tell us a few more things.
First, did you also have things like your hemoglobin, creatinine, and calcium levels reported in your latest blood test results? If so, what were those results?
Also, when were your previous free light chain and M-spike measurements, and what were they?
Finally, did your latest set of lab results include your latest M-spike? (It looks like you have an IgG M-spike of perhaps 1.6 g/dL, but that's just a rough guess based on your IgG level.)
What we need to figure out at this point is whether your new results are part of a trend, or if they're some sort of anomaly, and also whether other test results are reflecting the same sort of thing seen in your free light chain results.
Take care.
Before you draw too many conclusions from these most recent blood tests, perhaps you can tell us a few more things.
First, did you also have things like your hemoglobin, creatinine, and calcium levels reported in your latest blood test results? If so, what were those results?
Also, when were your previous free light chain and M-spike measurements, and what were they?
Finally, did your latest set of lab results include your latest M-spike? (It looks like you have an IgG M-spike of perhaps 1.6 g/dL, but that's just a rough guess based on your IgG level.)
What we need to figure out at this point is whether your new results are part of a trend, or if they're some sort of anomaly, and also whether other test results are reflecting the same sort of thing seen in your free light chain results.
Take care.
Re: Am I now smoldering rather than MGUS?
Hi Jack,
To add to Terry's great comments, your M-spike would be found on a test that has the name "electrophoresis" in it. It may also be labelled as M-protein, paraprotein, monoclonal protein, abnormal protein, or something like that. It may also appear as a separate entry on the lab report and may not necessarily show up on an online lab summary.
Technically, in order to be classified as smoldering, your M-spike must be >= 3 g/dL and / or you must have a bone marrow plasma cell percentage >= 10% (assuming you don't meet any of the CRAB criteria).
While your free light chain ratio is high, the high value is largely due to your lambda level being suppressed. This is good news since you don't want to have the situation where the involved free light chain (in your case, the kappa free light chain) be the one that is primarily contributing to a high ratio value. So, don't worry too much about your ratio being high.
However, you are suffering from immunoparesis (low IgA and low IgM), which does put you at a higher risk for progression to myeloma. So, it would be good to get routinely tested every few months, if you aren't already.
Lastly, you didn't mention which chromosomal mutations you have. If you don't know, you should ask your doctor for a list of the ones he / she is concerned about.
To add to Terry's great comments, your M-spike would be found on a test that has the name "electrophoresis" in it. It may also be labelled as M-protein, paraprotein, monoclonal protein, abnormal protein, or something like that. It may also appear as a separate entry on the lab report and may not necessarily show up on an online lab summary.
Technically, in order to be classified as smoldering, your M-spike must be >= 3 g/dL and / or you must have a bone marrow plasma cell percentage >= 10% (assuming you don't meet any of the CRAB criteria).
While your free light chain ratio is high, the high value is largely due to your lambda level being suppressed. This is good news since you don't want to have the situation where the involved free light chain (in your case, the kappa free light chain) be the one that is primarily contributing to a high ratio value. So, don't worry too much about your ratio being high.
However, you are suffering from immunoparesis (low IgA and low IgM), which does put you at a higher risk for progression to myeloma. So, it would be good to get routinely tested every few months, if you aren't already.
Lastly, you didn't mention which chromosomal mutations you have. If you don't know, you should ask your doctor for a list of the ones he / she is concerned about.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Am I now smoldering rather than MGUS?
Well, went to see my new myeloma doctor yesterday. I was diagnosed last August with MGUS.
Seems I am one of the unlucky 1-2% of MGUS patients that move on to smoldering. Not only that, but I also show chronic lymphocytic leukemia / small lymphocytic lymphoma. As I have deletion 17P, he is going to aggressively test and monitor.
Can anyone shed light on what to expect moving forward?
For some reason he suspects some involvement in my bowel/colon, and he's ordered a colonoscopy. Does anyone know what the issue there might be?
So glad I went to see my oncologist after my visit with my last myeloma doctor. After looking at my test results, the old doctor and I just didn’t agree. My oncologist agreed and sent me to the head of the myeloma department. Not only did he agree with me, but filled me in on some other problems I had not noticed.
Thanks to those that read my previous post and advised me to get a second opinion!
Seems I am one of the unlucky 1-2% of MGUS patients that move on to smoldering. Not only that, but I also show chronic lymphocytic leukemia / small lymphocytic lymphoma. As I have deletion 17P, he is going to aggressively test and monitor.
Can anyone shed light on what to expect moving forward?
For some reason he suspects some involvement in my bowel/colon, and he's ordered a colonoscopy. Does anyone know what the issue there might be?
So glad I went to see my oncologist after my visit with my last myeloma doctor. After looking at my test results, the old doctor and I just didn’t agree. My oncologist agreed and sent me to the head of the myeloma department. Not only did he agree with me, but filled me in on some other problems I had not noticed.
Thanks to those that read my previous post and advised me to get a second opinion!
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penbed - Name: Jack D. Lovett
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: August 2017
- Age at diagnosis: 70
Re: Am I now smoldering rather than MGUS?
Just had new bone marrow test. Some of my results have gotten slightly worse. My plasma cell has jumped to 45%. August of last year I was 8%, last May 15%.
With my kappa-lambda free light chain ratio I am considered stage one. The doctor is hesitant to start treatment until next round of test in four months. With some of my chromosomal deletions I am not a candidate for normal treatments.
This has all happened so fast my head is spinning!
With my kappa-lambda free light chain ratio I am considered stage one. The doctor is hesitant to start treatment until next round of test in four months. With some of my chromosomal deletions I am not a candidate for normal treatments.
This has all happened so fast my head is spinning!
-
penbed - Name: Jack D. Lovett
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: August 2017
- Age at diagnosis: 70
5 posts
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