My Kappa is 238 mg/L and Kappa/Lambda is 20. I was diagnosed with MGUS 8 years ago and I am 70. Numbers 7 years ago were 20 and 2.4, and they started creeping up 5 years ago. Risk of MM is 1% each year, so most of us won't get MM and will stay asymptomatic. My oncologist focuses more on CRAB, high blood calcium (indicated de-ossification of bones), renal function, anemia, and bones (SMM and MM can be associated with bone lesions and breaks). So, my Kappa is ramping up but I may still never get to the smoldering stage because my bloodwork is good. BTW, some meds can impact bloodwork numbers if they are metabolized through the kidneys or liver.