I have been recently diagnosed in April with multiple myeloma. My numbers have concerned me. Why is the ratio so high? It looks off the chart.
Component Your Value Standard Range
Kappa Free Light Chains QNT 2150.00 mg/L 3.30 - 19.40 mg/L
Lambda Free Light Chains QNT 8.46 mg/L 5.71 - 26.30 mg/L
Free Kappa/Lambda Ratio 254.14 0.26 - 1.65
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pamjoy - Name: pamjoy
- Who do you know with myeloma?: Me and a friend
- When were you/they diagnosed?: April 2016
- Age at diagnosis: 60
Re: Why is my kappa / lambda ratio so high?
Your numbers are high but in isolation it does not mean that you have multiple myeloma. Did they do a PET or bone scan that showed lesions? Did they do a bone marrow biopsy and if so what were the results? They also should have done serum protein electrophoresis that would have identified if you had any excess paraprotein bands (M spike) and the size of it. Also an immunofixation test to identify the type of excess paraprotein being produced (example IgG kappa). Also a CBC to determine if you are anemic or have a compromised immune system and a chemistry panel to determine kidney function and calcium levels.
Assuming that you have multiple myeloma, your oncologist will recommend starting a course of treatment. The most common now being used in the U.S. as induction therapy is Velcade, Revlimid and dexamethasone (VRD or RVD). Most patients respond very positively to this triplet. After induction you may or may not move on to an autologous stem cell transplant (ASCT).
Assuming that you have multiple myeloma, your oncologist will recommend starting a course of treatment. The most common now being used in the U.S. as induction therapy is Velcade, Revlimid and dexamethasone (VRD or RVD). Most patients respond very positively to this triplet. After induction you may or may not move on to an autologous stem cell transplant (ASCT).
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Why is my kappa / lambda ratio so high?
Pamjoy,
You say that you were diagnosed in April. When did you begin treatment? It would help to know your values when you were diagnosed, and if you have had any labs in the interim, or if these are the first set?
Also, what type of myeloma do you have? Is it the light chain variety, and what is your isotope, IgG, IgA or IgM? I know it's a lot, but it would also be helpful to know your other primary markers, such as your hemoglobin and creatinine. Did you have myeloma symptoms at diagnosis, or was the myeloma diagnosed due to abnormalities in your blood work -- i.e., high protein or calcium values? Were you anemic, and, if so, are you now? Do you have bone disease (fractures and/or lesions)?
With myeloma, there are many factors to consider when evaluating response to treatment.
FYI, I was diagnosed with kappa light chain myeloma 2 years ago. My kappa light chains at diagnosis were over 12,000. They came down very rapidly with treatment, so even though they were quite high, I had a very good response to treatment.
Please fill us in on the details of your case. As you probably know, myeloma is a complex disease, and more information is needed in order to weigh in on the significance of your current light chain values.
Ellen Harris
You say that you were diagnosed in April. When did you begin treatment? It would help to know your values when you were diagnosed, and if you have had any labs in the interim, or if these are the first set?
Also, what type of myeloma do you have? Is it the light chain variety, and what is your isotope, IgG, IgA or IgM? I know it's a lot, but it would also be helpful to know your other primary markers, such as your hemoglobin and creatinine. Did you have myeloma symptoms at diagnosis, or was the myeloma diagnosed due to abnormalities in your blood work -- i.e., high protein or calcium values? Were you anemic, and, if so, are you now? Do you have bone disease (fractures and/or lesions)?
With myeloma, there are many factors to consider when evaluating response to treatment.
FYI, I was diagnosed with kappa light chain myeloma 2 years ago. My kappa light chains at diagnosis were over 12,000. They came down very rapidly with treatment, so even though they were quite high, I had a very good response to treatment.
Please fill us in on the details of your case. As you probably know, myeloma is a complex disease, and more information is needed in order to weigh in on the significance of your current light chain values.
Ellen Harris
Re: Why is my kappa / lambda ratio so high?
Four sets - 1100, 1300, 2450, 2150. I start treatment on Monday with the triple drug combo. They say I have the kappa light chain multiple myeloma. I originally went in thinking I fractured my wrist from a fall in my living room. My general doctor ordered x-rays and saw the lesions right away. They were quite noticeable, plus I have a swelling on top of my head. At first glance she though it was fatty tissue, but later learned it was part of myeloma.
Everything happened so fast that first week which was the last days of April. At first I was given Zometa but had so many side effects, it landed me in the hospital. I have done all the tests and decided to be considered for a study.
Immunofixation Result, Serum
Serum immunofixation electrophoresis confirms the presence of a minor M-spike (M1) in the beta-1-region, consisting of free monoclonal kappa light chains. There is a second, minor free kappa M-spike (M2) in beta-2.
SPE/IFE reveals two M-spikes in the beta region, both free monoclonal kappa light chains (see serum IFE). The beta-1-region harbors M1 and is 0.5 gm/dL, identical to the 0.5 gm/dL observed on 23 May 2016; these quantitations include normal beta-1-protein. The beta-2-region harbors M2 that was first noted on 23 May 2016 but was probably present, in retrospect, on the gel of 22 Apr 2016 where it was interpreted as being part of the polyclonal kappa smear; M2 is 0.3 gm/dL, similar to the 0.2 gm/dL observed on 23 May 2016. The quantitation of M2 includes normal beta-2-protein. Previous quantitations include:
M1: 0.5 gm/dL;
M2: not reported but probably present, in retrospect, on 22 Apr 2016
Gamma 0.51 gm/dL 0.60 - 1.60 gm/dL
Beta-2 Microglobulin 3.01 mg/L 0.70 - 1.80 mg/L
BUN 23 mg/dL 7 - 17 mg/dL
BUN/Creatinine Ratio 35.9 <25.0
Calcium 10.1 mg/dL 8.4 - 10.2 mg/dL
Total IgG 685 mg/dL 700 - 1600 mg/dL
IgA 67 mg/dL 70 - 400 mg/dL
IgM <20 mg/dL 40 - 230 mg/dL
All others are in the normal range.
Everything happened so fast that first week which was the last days of April. At first I was given Zometa but had so many side effects, it landed me in the hospital. I have done all the tests and decided to be considered for a study.
Immunofixation Result, Serum
Serum immunofixation electrophoresis confirms the presence of a minor M-spike (M1) in the beta-1-region, consisting of free monoclonal kappa light chains. There is a second, minor free kappa M-spike (M2) in beta-2.
SPE/IFE reveals two M-spikes in the beta region, both free monoclonal kappa light chains (see serum IFE). The beta-1-region harbors M1 and is 0.5 gm/dL, identical to the 0.5 gm/dL observed on 23 May 2016; these quantitations include normal beta-1-protein. The beta-2-region harbors M2 that was first noted on 23 May 2016 but was probably present, in retrospect, on the gel of 22 Apr 2016 where it was interpreted as being part of the polyclonal kappa smear; M2 is 0.3 gm/dL, similar to the 0.2 gm/dL observed on 23 May 2016. The quantitation of M2 includes normal beta-2-protein. Previous quantitations include:
M1: 0.5 gm/dL;
M2: not reported but probably present, in retrospect, on 22 Apr 2016
Gamma 0.51 gm/dL 0.60 - 1.60 gm/dL
Beta-2 Microglobulin 3.01 mg/L 0.70 - 1.80 mg/L
BUN 23 mg/dL 7 - 17 mg/dL
BUN/Creatinine Ratio 35.9 <25.0
Calcium 10.1 mg/dL 8.4 - 10.2 mg/dL
Total IgG 685 mg/dL 700 - 1600 mg/dL
IgA 67 mg/dL 70 - 400 mg/dL
IgM <20 mg/dL 40 - 230 mg/dL
All others are in the normal range.
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pamjoy - Name: pamjoy
- Who do you know with myeloma?: Me and a friend
- When were you/they diagnosed?: April 2016
- Age at diagnosis: 60
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