What to think when only free light chain ratio is abnormally high?

Posted by georgiagurl @georgiagurl, Nov 2, 2025

I went to a hemotologist because I had a blood clot and needed to know if I needed to take a blood thinner forever. I am a 68 year old female and when blood work came back, it said my free light chain ratio was 101.55, kappa light chain was 89.36 and the spep test said "a small amount of free kappa monoclonal protein (too small to quantitate) is present." I had never heard of these tests and was surprised something was listed as abnormal. I have no symptoms and all other blood work was normal. I am scheduled for a bone marrow biopsy. When only a ratio if high, and nothing else is abnormal, is this something to be concerned about or is it a monitor and watch thing?

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Profile picture for Colleen Young, Connect Director @colleenyoung

@stephiew, welcome. Are you living with a blood disorder? How are you doing?

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@colleenyoung I am seeing a myeloma specialist. I have light chain only smoldering myeloma and it appears the Kappa along with the ratio are moving toward active myeloma. I have taken the position after smoldering for nearly a year that if it progresses, I won't be too upset because it's not like I brought it on myself. If it happens, it happens and thankfully, newer drugs are coming through the pipeline such that I will not die from this disease but from something else. I hear that some folks are able to get off maintenance after a long period of time so it seems it won't be so bad once under control. I may sound naive but I refuse to worry over something where so many promising developments are occurring.

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