I have IgA Kappa free light chain smouldering multiple myeloma (SMM) (my MGUS [monoclonal gammopathy of unknown significance] progressed to precancerous SMM last summer after 10 years of MGUS). MGUS doesn't progress to SMM or MM for most people. IgA is a type of immunoglobulin, elevated means it is higher due to inflammation, your bodie's response to illness, MGUS, or other. My current kappa/lambda ratio is 75. Bone marrow biopsies can be a bit scary (no pain with mine) but give a lot of information about the cellular composition of your bone marrow, and potential genetic risk factors.