My father has started taking Zometa since January 2015. The first two shots were hard to bear. But now he is doing ok. He takes the shot and still goes to work.
We however noticed that his kappa, together with the kappa-lambda ratio, continues to increase since he started the treatment. Has anyone taken Zometa and experienced the same thing?
His kappa is 35.09, lambda 12.54, and the ratio is 2.80 today. It was 29.53, 13.14, and 2.20 in January before he started treatment. I am wondering if the treatment is causing the disease to progress?
Please share your experience with me.
Thank you
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Re: Zometa and kappa-lambda ratio
Hi Yemesrach!
If the test results you shared in your posting are for the serum (blood) free light chain test, then the change in your father's kappa level isn't really that significant, especially if the difference was seen between just two tests (one in January, and one recently).
But, just to make sure, could you check whether your father's light chain levels being tested using the serum (blood) free light chain test? Also, are the units for the test results mg/dL (milligrams per deciliter)?
The one thing you may want to check is your father's creatinine level, which reflects the health of his kidneys. Zometa sometimes can cause damage to the kidneys, and, if that is happening, you would see increases in your father's creatinine level. I believe that changes in kidney function also can affect light chain levels, although I don't know whether there is more of an effect on kappa levels than on lambda levels.
Does your father have smoldering myeloma? Zometa by itself isn't really a myeloma treatment. There has been one study done that suggests that it can have an anti-myeloma effect, but it's usually given to help build the bones of myeloma patients -- not as a treatment for myeloma itself.
I hope this helps at least a little. Let us know if you have more questions.
If the test results you shared in your posting are for the serum (blood) free light chain test, then the change in your father's kappa level isn't really that significant, especially if the difference was seen between just two tests (one in January, and one recently).
But, just to make sure, could you check whether your father's light chain levels being tested using the serum (blood) free light chain test? Also, are the units for the test results mg/dL (milligrams per deciliter)?
The one thing you may want to check is your father's creatinine level, which reflects the health of his kidneys. Zometa sometimes can cause damage to the kidneys, and, if that is happening, you would see increases in your father's creatinine level. I believe that changes in kidney function also can affect light chain levels, although I don't know whether there is more of an effect on kappa levels than on lambda levels.
Does your father have smoldering myeloma? Zometa by itself isn't really a myeloma treatment. There has been one study done that suggests that it can have an anti-myeloma effect, but it's usually given to help build the bones of myeloma patients -- not as a treatment for myeloma itself.
I hope this helps at least a little. Let us know if you have more questions.
Re: Zometa and kappa-lambda ratio
Cheryl G has done a nice job answering this.
The change in the light chains are not significant.
The change in the light chains are not significant.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Zometa and kappa-lambda ratio
Dear Cheryl G and Dr. Valent,
Many thanks for your kind reply. It is a great relief to know that the changes are not significant.
I checked the result. It is "Free K+L Chains, Qn, S". The measurement for kappa is 35.09 mg/L and the lambda is 12.54 mg/L.
Creatinine, Serum is 1.04 mg/dl; BUN/ Creatinine ratio 11.
I hope it is still fine with this number. I will continue to monitor his creatinine levels to be sure that his kidney is ok. Thanks for the heads up.
Many thanks again for your kind response.
Best regards,
Yemesrach
Many thanks for your kind reply. It is a great relief to know that the changes are not significant.
I checked the result. It is "Free K+L Chains, Qn, S". The measurement for kappa is 35.09 mg/L and the lambda is 12.54 mg/L.
Creatinine, Serum is 1.04 mg/dl; BUN/ Creatinine ratio 11.
I hope it is still fine with this number. I will continue to monitor his creatinine levels to be sure that his kidney is ok. Thanks for the heads up.
Many thanks again for your kind response.
Best regards,
Yemesrach
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Yemesrach
Re: Zometa and kappa-lambda ratio
One more thing. We were told that he is smoldering even if he has some lytic lesions in the x ray. They were very small. We did get a second opinion and they felt that he is smoldering even if he has these small lesions.
I am not sure how we feel. With the new guidelines, we checked again, and still the myeloma specialist thinks that we should only do Zometa for now and wait and see. So we are really hoping that the bone lesions will be fixed and he will remain smoldering.
I am not sure how we feel. With the new guidelines, we checked again, and still the myeloma specialist thinks that we should only do Zometa for now and wait and see. So we are really hoping that the bone lesions will be fixed and he will remain smoldering.
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Yemesrach
Re: Zometa and kappa-lambda ratio
Yemesrach,
Remember that the new diagnosis criteria are simply guidelines.
I would call attention Dr. Rajkumar's closing statement in the following article:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
It's good that you got a second opinion on this important matter.
Remember that the new diagnosis criteria are simply guidelines.
I would call attention Dr. Rajkumar's closing statement in the following article:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
Finally, no written criteria can substitute clinical judgment. In many cases, physicians will need to continue to use judgment in making decisions on which patients need immediate therapy, and in deciding when continued observation will be in the patients’ best interests."
It's good that you got a second opinion on this important matter.
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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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