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

Posted by georgiagurl @georgiagurl, 1 day ago

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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Chris, Volunteer Mentor | @auntieoakley | 1 day ago

@georgiagurl all of these tests combined with the bone marrow biopsy should give you more answers. My husband has light chain myeloma, and his SPEP would no longer accurately monitor his myeloma. His numbers were quite high of lambda light chains, which caused a kidney injury. The bone marrow biopsy gave the doctors the answers they needed to treat him and his kidneys are recovering.
Unfortunately they probably won’t be able to answer your question before that biopsy. When is that scheduled? Will you come back after and let me know what they find?

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georgiagurl | @georgiagurl | 1 day ago

I am waiting for hospital to call (hopefully tomorrow) to up the biopsy appt. I will let you know.

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swalex | @swalex | 1 day ago

A small amount of a kappa-type monoclonal protein was also found, but it's too little to measure precisely.
Your test results show a high level of kappa free light chains in your blood, with a very high free light chain ratio of 101.55 (normal is around 0.26 to 1.65). This means there's a much larger amount of kappa chains compared to lambda chains, which is not typical.
The kappa light chain level itself is also elevated at 89.36 mg/L (normal is about 3.3 to 19.4 mg/L). These findings suggest that a group of identical plasma cells (a "clone") is making too many kappa light chains, which may be a sign of a condition like MGUS, multiple myeloma, or another plasma cell disorder.
While this doesn’t confirm cancer, it is an abnormal result that needs further evaluation by a specialist.
Next step: CBC, calcium, creatinine (to assess anemia, kidney function, etc.)

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georgiagurl | @georgiagurl | 1 day ago
In reply to @swalex "A small amount of a kappa-type monoclonal protein was also found, but it's too little to..." + (show)
Profile picture for swalex @swalex

A small amount of a kappa-type monoclonal protein was also found, but it's too little to measure precisely.
Your test results show a high level of kappa free light chains in your blood, with a very high free light chain ratio of 101.55 (normal is around 0.26 to 1.65). This means there's a much larger amount of kappa chains compared to lambda chains, which is not typical.
The kappa light chain level itself is also elevated at 89.36 mg/L (normal is about 3.3 to 19.4 mg/L). These findings suggest that a group of identical plasma cells (a "clone") is making too many kappa light chains, which may be a sign of a condition like MGUS, multiple myeloma, or another plasma cell disorder.
While this doesn’t confirm cancer, it is an abnormal result that needs further evaluation by a specialist.
Next step: CBC, calcium, creatinine (to assess anemia, kidney function, etc.)

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@swalex : All of those tests you list were normal.

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