I am new and learning and know little, but I have seen it mentioned in various places that >1.5g/dL is a higher risk category. You are well under that at .2 g/dL. Your ratio seems low to me as well. I think in some cases the m-spike is not always the most important metric as well, so I'm sure they will look at a range of factors. I'm sure your hematologist will clarify things and get further tests as necessary, but hopefully they say you land in a lower risk group, with a relatively low 1% chance per year of progression. I'm waiting on a better understanding of mine, but I am 1.6g/dL, with a 5:1 Lamba ratio so I suspect I'm in the higher risk category. On my first test though I was a 1.9g/dL so I want to understand how much variability there is, how it looks over time, etc, and in the mean time I'm just using it as motivation to get in much better shape via nutrition, lifestyle, vitamins, etc.

Let me know what they say and good luck!