Is it normal for free light chains to fluctuate?

Hi everyone,
My situation is slightly different. I was told I have a high-risk kappa disease. I have had two transplants back to back, and, finally, we achieved MGUS like state. It has been almost 1.5 since the last transplant.
Kappa numbers slowly decreased. It seems to fluctuate slightly.
I get tested every month, and the last test just revealed a 9-point increase. The M spike is stable at .5 (it was 2.5), and lambda is normal.
I am on Revlimid, Ninlaro, Darzalex, Dexamethazone ( just lowered to 5 mg a week) combination drugs.
That is my story.

I have monoclonal protein in urine not blood.

Serum KLCF is 75
Serum LLCF is 10.8
Serum KL/LCFR is 6.99
Do I have to have monoclonal protein in blood to have MM?
What is my risk?
TIA
KKC

You can have FLC in urine and not blood. This can happen early on. It’s helpful to know what your M protein level is. I believe your levels are in the MGUS range. MM range is either k or l over 100 and M protein 3.0 or above. MGUS is considered benign but a precursor to MM. it requires monitoring of the FLC and not everyone progresses to MM, thankfully. These disorders are quite complex but there is a lot of information on the internet. Just stick to reliable sources. The risk of progression is actually quite low which is encouraging.

@kakc19
I am not medically trained, but I suspect that you will have more screening before you are diagnosed. Your physician may opt for a bone marrow biopsy and scans to check for bony lesions.
https://www.mayoclinic.org/diseases-conditions/mgus/symptoms-causes/syc-20352362
One thing to keep in mind, is that this pesky M protein presents differently in almost every person I speak to on Connect. We are all so different, largely due to coexisting medical conditions, age and physical stamina.
What type of physician have you been working with and what does he or she say?

I just had some test because I started getting numb tingling feet and now lower legs on both sides. I have been seeing a Neurologist and have a new doctor now. They ran some tests that my former Neurologist did not run. So is this peripheral neuropathy caused by my meds I take for two liver transplants over 24 years.

1. My Kappa Lightcell Serum levels are high and my lambda lightcell serum is normal.

2. Then my M protein is negative.

Now I am concerned about some sort of cancer that is there or developing. And what kind is it.

I read about MGUS and it seems related to my recent tests. What do I need to say to or ask questions to my doctor in a followup appointment in 6 months? Or, should I push to see them sooner?

@bbc2024, when you say you had 2 transplants, do you mean bone marrow transplants?

Sorry no, they were liver transplants. Suddenly I was tested by my Neurologist with this alpha and lambda lightcell serums. I saw the test results from my doctor through My Chart app and got scared that I might have some sort of cancer. Then I saw the M protein test was negitive. My concern was I had a bone marrow test done before my first liver transplant and they said there was no cancer however that was 25 years ago. I've been on immune surpressant for 24 years no from my first transplant. I was told that certain diseases can take place like cancer from taking immune surpressants like I have done. So now I an scared that I might be getting some sort of blood disease now. I saw articles on MSUG and they talk about both tests I just had a few weeks back.

Can a 2 week severe bought with influenza slightly increase the FLC ratio to 1.85? This is minimally outside of normal, and my platelets (379), phospholipid IGM (150), CRP (5.3), Monoclonal Aloha 2 Globulin (1.1). All other antibody and other bloodwork were normal (20 tubes)!! I’m rarely if ever sick. I’ve been reading that all of these slightly above normal results can be the result of a mobilized immune system fighting a virus or infection. I was so sick for almost 14 days with fever, chills, joint pain, sore throat, head ache, and bronchitis that kept me up with coughing fits for more than a week. Because of these blood test results, they are ordered many more while I’m still on the healing end of the flu. Shouldn’t we wait u til I’m completely recovered and retest then?

@michellecr, sounds like you had a terrible bout of the the flu. I hope you are fully recovered now. How were the results of the repeat testing? How are you doing?

They ended up canceling the 2bd blood test. Duplicates in error. Waiting on the 24 hr test results. They seem to take a week or more. I’m not sure why urine results take longer than blood test results but it’s notable.