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M-Spike, High Kappa and Kappa/Lambda Ratio

Posted by Kappa King @kappaking, Mar 8, 2024

After experiencing chronic diarrhea for > four weeks, I decided to contact my gastro doctor. He ordered blood work and performed a colonoscopy and upper endoscopy with various biopsies. The colonoscopy, upper endoscopy and biopsies showed no sign of cancer or microscopic colitis, however the blood work showed a quite elevated IgA level. He referred me to a hematologist/oncologist who did further blood work, the results of which showed:

• Borderline low white blood count
• Borderline high red cell distribution width
• Low lymphocytes
• Low monocytes

And the most troublesome results:

• Kappa Free Light Chain Level: 290.7 mg/L, well outside of the 3.3-19.4 mg/L acceptable range
• Kappa/Lambda Ratio: 45, well outside of the .26-1.65 acceptable range
• IgA Level: 2111 mg/dL, well outside of the 70-400 mg/dL acceptable range
• IgG level of 698 mg/dL, barely outside of the 700-1660 mg/dL
• M-Spike: 1.29

There are other data points outside the reference ranges, but these are the ones that concern me most. I had been overseas when I received the results and asked my hematologist if I should cut my vacation short to come home for further evaluation/tests. He urged me not to do so and told me it can wait. I managed to enjoy my vacation but now that I returned I can't stop worrying. I'm following up with my hematologist to see what the next step is. I'm scared.

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rustypenny | @rustypenny | Jan 31 4:43pm
In reply to @ajbonett "When I was diagnosed with an M-spike 2 years ago which turned out to be IgG..." + (show)
@ajbonett

When I was diagnosed with an M-spike 2 years ago which turned out to be IgG MGUS. I checked with a retired oncologist friend who told me to make sure that I used a doctor associated with a major medical center. He did not have confidence in the local hematologists/oncologists when it came to dealing with multiple myeloma because they didn't see much of it. I followed his direction; and after speaking with other patients using local doctors, I am glad that I did. My numbers continue to climb slowly. My hemotologist/oncologist checks my bloodwork every 3 - 4 months. I receive iron infusions as necessary. He will start treatment if/when my "bad cells" reach 10%. At my last appointment, my light chain ratio was nearly twice what yours is, but I don't let it keep me down. I slow down/take breaks when I need to, and keep a positive attitude. I try to avoid sick people because of my lowered immune system. I have a little pain in my bones, but I treat with a turmeric & ginger tea, and/or an OTC pain reliever. I am now due for a bone scan. We will see if anything turns up. My advice: Make sure that you get a good doctor who is WELL INFORMED about Multiple Myeloma. Don't panic. Don't think this is the end of the road. You've got a long way to go yet, and it may not ever turn into full-blown MM. Just be sure to live your life in a way that is as good and as satisfying as you can make it. God bless!

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I have smoldering myeloma, I live in Boise,Id and I don't have great faith in our medical system. Does anyone have anyone have doctor recommendations? I am considering traveling to Rochester,Phoenix or the Bay area as I have relatives in those places if I needed to stay for a while. Thanks.

REPLY
1 reply
mattymatilda | @mattymatilda | Jan 31 5:21pm
In reply to @rustypenny "I have smoldering myeloma, I live in Boise,Id and I don't have great faith in our..." + (show)
@rustypenny

I have smoldering myeloma, I live in Boise,Id and I don't have great faith in our medical system. Does anyone have anyone have doctor recommendations? I am considering traveling to Rochester,Phoenix or the Bay area as I have relatives in those places if I needed to stay for a while. Thanks.

Jump to this post

I’m sorry to hear about your diagnosis. The Mayo Clinic is in Scottsdale Arizona and would be a great place to start here in Arizona. Just be sure and check that they take your insurance. I suffer from the same, and there is not a large population of actual hematologist Oncologist specialized in multiple myeloma. I hope you can find somewhere where you feel more confident in the medical care.

REPLY
msh466 | @msh466 | Feb 4 5:15pm

I guess I can share my story. I must of had MAGUS at some point in my life. For I have SMM IGA Lambda. It was found with routine blood work (shock) that I have a dual spike M protein present. This was found by my neurologist. Numbness of hands and feet with abnormal ECG scans which pointed to sheathing of nerve fibers caused by M protein. So switch to Hematologist. PET scans and MRI all normal. No CRAB present. What complicated this is my celiac disease as this to causes elevated IGA. So yes my IGA is off the charts. M protein right around 1g/dl. Ratio normal. Lots of free light chains floating around but so far have not tipped the scale. Bone marrow 15% PC. That is worrisome. Also 1q gain is not good. Genetics studies get down to the nitty gritty of chromosomal abnormalities. I am now considered high risk now. But my latest Chem and heme results are perfect. No sign of anemia or kidney issues. Been 8 month since first diagnosed. I’d be lying is I said it doesn’t influence me.

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