I’m never sure how many of you actually read the comments from our readers. One reason I started this blog and write here daily is to help share information between myeloma patients. I have always felt you can learn more from other patients than from your physicians or other medical staff. So for those of you that didn’t read these two comments following Friday’s post, I have reproduced them here:
Pat, sorry your recent test shows a faintly visible paraprotein. What tests are you referring to as the new more sensitive test? Is one of them the Freelite test? My wife is a nonsecretor. She has Lambda light chain proteins only. However, many times the serium protein electrophorisis test will indicate a possible or weak monoclonal band. Then they do a immunofixation test and it normally indicates no monoclonal band identified. My understanding is that plasma cells secrete heavy chain proteins and light chain proteins. Then two heavy chain proteins and two light chain proteins combine to form a whole immunoglobulin but there are some left over parts which are the light chains. Since all the myeloma plasma cells are a clone then all the left over parts are either Lambda light chains or Kappa light chains. So your myeloma cells make an IgG Kappa type immunoglobulin with leftover Kappa light chain proteins. The Freelite test measures these free light chains. There is a normal range for both the Kappa and Lambda type and the ratio between them. It seems that this test may indicate a relapse sooner than the test for the M-spike since it is capable of measuring a small amount. However, I think you would need a few tests taken when you are in CR for a base line so you could detect the increase. The increase would be in only one type since the increase in myeloma cells would only produce one type. This is why the Kappa/Lambda ratio is more important If you had an infection your immune system would create more immunoglobulins that would increase both the Kappa and Lambda light chains but the ratio would not change as much.
October 24, 2009 8:22 PM
The serum free light chain kappa & lambda with ratio is a very sensitive snapshot of possible myeloma activity. It can detect a problem before SPEP and immunofixation results indicate a relapse. My husband’s oncologists always order it as well as SPEP and immunofixation to monitor his myeloma (IgG lambda).
Pat, I hope you don’t give a s&*#t whether or not the pathologist thinks your onc. orders blood tests too frequently. If the pathologist had myeloma, he or she would be monitoring the markers monthly, you can bet on that. If my husband’s oncologist wanted to go to testing every 6 months, we would fire him in a New York minute.
My husband has been in CR since his SCT in 7/07. Every quarter I dread the lab results that may come back “monoclonal protein detected” – so far we have dodged that bullet. I hope our luck holds out for many, many quarters more.
I want to thank you for your wonderful blog, and wish you the best in your journey with myeloma.
October 25, 2009 1:03 PM
Great insight Patricia and Jerry! Thanks for sharing! I know many of you have had to, or will have to deal with testing irregularities and, eventually your myeloma becoming active.
Feel good and keep smiling! Pat