Kappa/Lambda ratio

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Kappa/Lambda ratio

by YanaMom on Tue Nov 18, 2008 12:00 AM

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Hi, mom (MM Bence Jones Kappa) is stable, her blood is fine and her Kappa has stabilised around 61. However, her Lambda is worrying - jumping from 1.5 to 2,5 and, therefore her kappa/lambda ratio can be above 300 which is not good. I have read somewhere that supressed lambda is usually a result of chemo (which mom had and which was supposed to supress kappa instead but hadn't). Does lambda ever recover back up? And what stable Kappa but decreasing Lambda mean for a Kappa-chain patient? I am out of my league here, please help...

Yana

RE: Kappa/Lambda ratio

by poppycath on Tue Nov 18, 2008 12:00 AM

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Hi Yana--=

Do you have a copy of 'Understanding Serum Free Light Chain Assays' from the International Myeloma Foundation(IMF)? It clearly goes into all aspects of the Bence Jones issue.  Under the Serum Free Light Chain Assays: Normal Versus Abnormal it says:

"Normal levels of serum free light chains are*:

Kappa: 3.3 -19.4 mg/L*

Lambda: 5.7 -26.3 mg/L*

Kappa/lambda ratio: 0.26- 1.65

*NOTE: The units here are mg/L; different laboratories use different units It is important t double-check the units used when comparing numbers in lab values.

The Kappa/Lambda Ratio

1. The kappa/lambda ratio is as important for diagnosis and monitoring of myeloma as are the levels of kappa and lambda. 2. When the level of either kappa or lambda is very high and the other chain is normal or low, then the ratio is abnormal and indicates that the myeloma is active. 3. If levels of both kappa and lambda light chains are increased, the ratio may be within the normal range, and this generally indicates a disease other than myeloma, such as poor kidney function. When the kidneys are not working properly, both types of light chains are retained in the blood and are not removed by the kidneys.  The result is increased levels of both kappa and lambda in the blood.  In this situation, in general, the abnormally increased levels are not themselves a direct result of currently active myeloma. 4. If the kappa and lambda levels are both within the normal range, sometimes the ratio may be abnormal.  In this situation there may be a persistent low level of active myeloma with excess production of the abnormal light chain. 5. A normal kappa/lambda ratio after treatment is particularly good remission and is termed a stringent complete response.  Normalization of the kappa/lambda ratio correlates with possible longer remission and studies are in progress to investigate more about the nature of this relationship,

Yana, this comes directly from the aforenamed booklet.  You can get a complete set of myeloma information from the IMF by going online and ordering it -- for FREE!  Its a great resource and they have many other things relative to myeloma patients and carers -- the site is well worth a look!!  I don't know if this answers your question, but its a good place to start.  Best wishes, Cath

RE: Kappa/Lambda ratio

by YanaMom on Sat Nov 22, 2008 12:00 AM

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Cath,

thank you - so Lambda level doesn't matter...

I also saw data which says that if before chemo Lambda (in our case) is normal it is very likely to become supressed afterwards as a result of chemo. So considering it was a lower number to start with however little it gets supressed , percentagewise it is still bigger number than Kappa supression - hence the ratio worsens. Awful really.

Yana

RE: Kappa/Lambda ratio

by UTboy on Mon Nov 24, 2008 12:00 AM

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Yana - my doc was interviewed by the folks who market Freelite and the article provides some interesting opinion from a M.D./P.H.D who has treated/researched MM for many years.   I have Lambda light chain disease myself....and despite much reading, I'm still a little foggy on the subject.   My kappa is jkust as low as my lambda.  My doc told me not to worry about the Kappa....so I don't.   Here's the article

http://www.huntsmancancer.org/groups/myeloma/pdf/freeliteUpd

RE: Kappa/Lambda ratio

by YanaMom on Thu Nov 27, 2008 12:00 AM

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thank you for the info. it is awful, though. UAMS claims mom is stable with her kappa around 600 for a few months, these people say that she is to have unfavourable outcome as kappa is high and so is kappa/lamba ratio. back to square one for me, I am afraid.

RE: Kappa/Lambda ratio

by marsbars on Thu Dec 04, 2008 12:00 AM

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On 11/27/2008 YanaMom wrote:

thank you for the info. it is awful, though. UAMS claims mom is stable with her kappa around 600 for a few months, these people say that she is to have unfavourable outcome as kappa is high and so is kappa/lamba ratio. back to square one for me, I am afraid.

 

I also have the Bence Jones type MM.  My doc tells me that the Kappa, Lambda (5 catagoreis each) has to do with measuring protein in the blood.  The doc's can help get these under control.  Not to discount the medical terms, but sometimes we patients get in over our heads trying to figure out what the medical info really is telling us.  The doc's help with these somewhat, but if you go online to the IMF and read about Free Lite Chains (protein in our blood)  it will help you understand what's happening to the body with this cancer.  The main thing you and your doctor need to figure out is how to get the protein back to a normal level in the blood.  It's a continual learning curve I know.  We will prevail!  Good luck and blessings from Maryland!

RE: Kappa/Lambda ratio

by YanaMom on Sun Dec 07, 2008 12:00 AM

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On 12/4/2008 marsbars wrote:

 

On 11/27/2008 YanaMom wrote:

thank you for the info. it is awful, though. UAMS claims mom is stable with her kappa around 600 for a few months, these people say that she is to have unfavourable outcome as kappa is high and so is kappa/lamba ratio. back to square one for me, I am afraid.

 

I also have the Bence Jones type MM.  My doc tells me that the Kappa, Lambda (5 catagoreis each) has to do with measuring protein in the blood.  The doc's can help get these under control.  Not to discount the medical terms, but sometimes we patients get in over our heads trying to figure out what the medical info really is telling us.  The doc's help with these somewhat, but if you go online to the IMF and read about Free Lite Chains (protein in our blood)  it will help you understand what's happening to the body with this cancer.  The main thing you and your doctor need to figure out is how to get the protein back to a normal level in the blood.  It's a continual learning curve I know.  We will prevail!  Good luck and blessings from Maryland!

 

I did read the IMF - and unless I read the wrong one it doesn't say much, at least not about the 5 categories - can you please please tell me more about it or send a link? --Message edited by CancerCompass staff. For personal protection, email address removed. Consider private reply. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html--

RE: Kappa/Lambda ratio

by marsbars on Tue Dec 09, 2008 12:00 AM

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On 12/7/2008 YanaMom wrote:

 

On 12/4/2008 marsbars wrote:

 

On 11/27/2008 YanaMom wrote:

thank you for the info. it is awful, though. UAMS claims mom is stable with her kappa around 600 for a few months, these people say that she is to have unfavourable outcome as kappa is high and so is kappa/lamba ratio. back to square one for me, I am afraid.

 

I also have the Bence Jones type MM.  My doc tells me that the Kappa, Lambda (5 catagoreis each) has to do with measuring protein in the blood.  The doc's can help get these under control.  Not to discount the medical terms, but sometimes we patients get in over our heads trying to figure out what the medical info really is telling us.  The doc's help with these somewhat, but if you go online to the IMF and read about Free Lite Chains (protein in our blood)  it will help you understand what's happening to the body with this cancer.  The main thing you and your doctor need to figure out is how to get the protein back to a normal level in the blood.  It's a continual learning curve I know.  We will prevail!  Good luck and blessings from Maryland!

 

I did read the IMF - and unless I read the wrong one it doesn't say much, at least not about the 5 categories - can you please please tell me more about it or send a link? --Message edited by CancerCompass staff. For personal protection, email address removed. Consider private reply. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html--

 

 

Although my kappa number was at 400 in May, then June it was 624 in July 664, Aug 667, and in October it was 1620.  I started treatments and  Nov 30 it was down to 877 so we are getting it under control as treatment is working and I might be lower by now.  Be happy that she has Kappa type instead of the Lamda type, Lamda is harder on kidneys.

This is the booket that you will want to get from IMF, 2006 issue of Patient Handbook.  It explains they whole issue pretty well, but like I said, I had to study it over and over to get the real info that I needed from the booklet....it's in there but hard to find. 

Another booklet is the 2006 issue of Concise Review of the Diesase and Treatment Options.

 God bless you and your family and good luck.  We are all in this together and we know it's overwhelming at times.  Hang in there.

 from marsbars

 

 

 

RE: Kappa/Lambda ratio

by marsbars on Tue Dec 09, 2008 12:00 AM

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On 11/18/2008 YanaMom wrote:

Hi, mom (MM Bence Jones Kappa) is stable, her blood is fine and her Kappa has stabilised around 61. However, her Lambda is worrying - jumping from 1.5 to 2,5 and, therefore her kappa/lambda ratio can be above 300 which is not good. I have read somewhere that supressed lambda is usually a result of chemo (which mom had and which was supposed to supress kappa instead but hadn't). Does lambda ever recover back up? And what stable Kappa but decreasing Lambda mean for a Kappa-chain patient? I am out of my league here, please help...

Yana


 

yana,

You've divided your Kappa and Lamda ratio incorrectly according to the rules of the test.

Divide L into K = Ratio  then 1 is Perfect Ratio.

Your mom's numbers should be according to this as follows

61/1.5 = 40.7 and if you go to where it showing your number is 5 then

61/5 = 12.2

 

I hope this helps, as my husband helps me with these numbers and he keeps good graph records of all my tests.  I am thankful each day for him and all my MM group.

Good luck and God bless you all.

 

RE: Kappa/Lambda ratio

by YanaMom on Sun Dec 14, 2008 12:00 AM

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thank you...
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