Serum Free Light Chain Assays Understanding

I would like to know if anyone knows what the free kappa serum value has to be for a m-spike to show up in a protein electrophoresis test. My original m-spike was 0.7 in late April.. I was on thalomid and dexamethasone until mid-Sept when the m-spike could no longer be measured. I went off the medicine and since mid-Oct. my free Kappa serum has went from 42 mg/l to 85.7 mg/l. My free kappa/lambda raio has went from 5.0 to 8.8. I am not sure how serious this is and should I now consider a transplant. My Doctor is pushing the transplant option.

 

On 1/17/2008 rharri10 wrote:

I would like to know if anyone knows what the free kappa serum value has to be for a m-spike to show up in a protein electrophoresis test. My original m-spike was 0.7 in late April.. I was on thalomid and dexamethasone until mid-Sept when the m-spike could no longer be measured. I went off the medicine and since mid-Oct. my free Kappa serum has went from 42 mg/l to 85.7 mg/l. My free kappa/lambda raio has went from 5.0 to 8.8. I am not sure how serious this is and should I now consider a transplant. My Doctor is pushing the transplant option.

Good Evening;

I am not familiar with "free kappa serum value". Kappa Free Light Chain (3.30-19.40) and Lambda Free Light Chain (5.71-26.30) but not the former.

K/L Free Ratio should fall between 0.26-1.65.

Have you had a bone marrow biopsy showing the cellularity of the plasma cells? A skeletal survey showing the appearance of your bones? And a CT scan showing any abnormalities of you skeleton? What stage are you presently Dx?

I'd get those other tests done before I was talked into a SCT. You may be able to treat your MM with the newer meds being offered or even a change in your diet prior to going through a transplant. Stay informed.

Take care;

Kevin

 

 

 

Hi rharri10~~ I'd agree with Kevin on this one - have all the extra tests done BEFORE you even consider the transplant.  When the tests have been done, get copies of the report forms so that you can start your own file of results for the years to come.  The next step is to learn all you can about the various tests and just what their results mean.  The International Myeloma Foundation in the USA has a terrific set of FREE booklets which explain each and every aspect of Myeloma -- tests, treatments, etc.  Google their site and follow the prompts and they will send you their information - at no cost to you - within a couple of days.  Then read, read, read until your really do understand it all!!  If you have any questions, you can either pose them here or ask your doctor directly -- I've found that doctors appreciate having an informed discussion and answering questions which show that the asker has done previous research.  There are so many new drugs on the market now, and they are being used in combinations with up to 90% success rates.  The aim is to treat myeloma as a chronic rather than a terminal disease.  Transplants have been very successful for many people, but there are cases where things went really wrong.  Going forward with the most information you can get will hopefully avoid any mistakes.  The harvesting and transplant process is fairly traumatic and not to be undertaken lightly!  However, I am not considered a suitable candidate for transplant so it has never been an option for me -- I have  too many allergic reactions to the meds needed to be given before harvesting can even begin, so I think you are actually lucky that you have the option!!  Good luck to you as you start this journey.  Gather as much info as you can before making any major decisions -- I'm going into my 5th year now on only 10mg of Revlimid -no dexamethasone - every 21 days for the past 18 months and have never felt better since being diagnosed.  Take good care, there is a long road ahead.  Cath