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kappa free light chains

by Readertk on Mon Sep 19, 2011 2:14 pm

My husband's kappa free light chains have been on a steady rise over the past year going from 6.52 mg/L directly out of transplant to 16.7 mg/L. His ratio has always been abnormal, but never exceeding 2.0. His new blood test revealed a kappa free light chain value of 6.29 mg/L.

We are very excited about this test value, but mistrustful. Is it possible to see a steady incline only to drop to right out back to the great values post transplant? Or should we have the test run again? What causes these major jumps in values?

Thank you.

Readertk
Name: Tiffany
Who do you know with myeloma?: husband
When were you/they diagnosed?: December 2009
Age at diagnosis: 42

Re: kappa free light chains

by Dr. Edward Libby on Wed Sep 21, 2011 10:51 am

Hello,
The pattern of your husbands free light chain values and your question are not crystal clear to me but I think I understand. In a patient with normally functioning kidneys the serum free light chain ratio is the best value to follow....not the absolute value of the kappa or lambda. This is because these values are sensitive to kidney function and the serum free light chain ratio corrects for that issue. As you are noticing the absolute values of the serum kappa free light chains go up and down sometimes without reason. But, the ratio should smooth out those changes and will give you the best assessment of response.
Is your husbands kidney function normal?
Do you have the serum free light chain kappa lambda ratio results?
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: kappa free light chains

by DIZYDEE on Mon Sep 26, 2011 6:26 pm

Is Free chain light disease a cancer? My dad was just diagnosed and he is having a bone marrow biopsy tomorrow to see what stage it is in. They are starting him on prednisone and chemo this week. His creatinine level are 5.9 and his kappa blood work was 3000. Thank you

DIZYDEE

Re: kappa free light chains

by Dr. Edward Libby on Tue Sep 27, 2011 11:53 am

There are forms of multiple myeloma in which only a free light chain is secreted. Free light chains can be detected in the blood and in the urine. The bone marrow biopsy and other staging tests will help your oncologist to sort this out and give your father a definitive diagnosis and prognosis.
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: kappa free light chains

by elcohnhead on Tue Sep 27, 2011 12:25 pm

I have had Myeloma for 13 years, and I am currently on Velcade once a week by IV. Recently, my Kappa Free Light Chain test went from 63.25 in August of 2011 to 119.50 in September, while my SPEP test went from 3.3 to 3.6 during the same period. Do the FLC and SPEP test values correlate here, or can the Kappa Free Light Chain test give false readings, as it seems to have gone up much higher than the SPEP test did? My oncologist, who does not specialize in Myeloma want to continue on the Velcade another month, and if the FLC & SPEP test results stay high, then do a bone marrow biopsy. What should I do?
Thanks.

elcohnhead

Re: kappa free light chains

by laetetia on Wed Mar 07, 2012 9:32 pm

This interests me too. My partner has had multiple myeloma since 2001 and currently on Velcade sq twice weekly but free kappa light chains rose from 54.4 in January to 101 in February and kappa lamda ratio rose from 5.96 to 12.17 as free lamda has remained fairly stable. Does this mean the Velcade isn't working ?

laetetia
Who do you know with myeloma?: De facto
When were you/they diagnosed?: 2001
Age at diagnosis: 53

Re: kappa free light chains

by K_purohit on Tue Apr 09, 2013 1:40 am

Hello everyone,

My father is suffering from Multiple Myeloma (free kappa light chain). He was diagnosed in October last year (its been 6 months). He is undergoing chemotherapy (Lenangio and Decmax).

I learnt from Dr Libby's earlier post that "serum free light chain ratio" is the best value to follow. Accordingly, I am happy and believe that my dad is doing well because his as his K/L ratio has dropped from 310 to 1.39 to 1.3 to 1.13 (last 4 months). The "M" band is now absent in the blood tests and the same was never present in the urine tests.

What can be considered as a stable value for serum free light chain ratio? Does he need to continue chemotherapy? He does not have any pain either...

K_purohit

Re: kappa free light chains

by Ron Harvot on Tue Apr 09, 2013 12:32 pm

To answer your question as to how long on Chemo, I was diagnosed in Feb 2009 and had similar results with an intial treatment of VRD. The Velcade was an infusion every week and at the same time I took 40 mg of dex. The Revlimid was 10 mg for a 28 day cycle - on 21 days (oral pills) off 7 days. I reached a CR within 4 months but stayed on the original protocal for another 3 months until my oncologist started backing it down. It is 4 years later and I am still on a maintenance dosage of Velcade (subq now) once every 2 weeks and Dex of 12 mg once every 2 weeks. The point is for most of us, even those that reach CR or NCR we are on long term maintenance theropy. Some take chemo holidays but eventually come back as the numbers start to climb. There are some that have been off Chemo for years but they are in the vast minority. As you may have read this disease is very treatable but is not curable so it is chronic. I often use the diabetes analogy. That disease is "controlled" through drugs but is not curable. If a diabetic stops taking their medication they will relapse and have problems. multiple myeloma is similar in that regard. However, that is not keeping me down as you may read about my biking post where I set goals and actuall race. One multiple myeloma patient in his 70s has completed a full marathon in each of the 50 states and is still on medication. So many of us lead fairly normal lives with the disease.

I am so happy that your father had a great test result and hope this continues.

Ron

Ron Harvot
Name: Ron Harvot
Who do you know with myeloma?: Myself
When were you/they diagnosed?: Feb 2009
Age at diagnosis: 56

Re: kappa free light chains

by K_purohit on Wed Apr 10, 2013 1:35 am

Dear Ron Harvot

Thank you for sharing your story and these interesting and motivating anecdotes. I will share these with my father and also discuss the same with his oncologist.

Can you shed some light on the approximate monthly cost (probably in USD) for the treatment? One of the reasons why I wanted to know about the duration of the chemotherapy was because we are finding it increasingly difficult to afford these medicines. While I believe we were financially well to do, I am not sure how long we can sustain these expenses.

Thank you for all the help! We truly appreciate it! :)

K_purohit
Name: Khamir Purohit
Who do you know with myeloma?: my father
When were you/they diagnosed?: October 2012
Age at diagnosis: 57

Re: kappa free light chains

by tpt on Wed Apr 10, 2013 9:55 am

Ron,

Did you have ASCT? Thanks.

tpt

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