2018 - Myeloma Screening
Did my Myeloma Screening in Nov. 2018 and test results shows:
1. Free Light Chains, Serum - Abnormal
2. Kappa 44.5 (High) - Normal is 6.7 to 22.4
3. Lambda 12.7 - Normal is 8.3 to 27.0
4. Free Kappa / Lambda Ration at 3.50 (High) - Normal is 0.31 to 1.56
5. Monoclonal Band seen at IgM and kappa lanes
Doctor recommended additional test for Lymph Nodes and Marrow Tests
Myeloma Screening Report 1
Myeloma Screening Report 2
Myeloma Screening Report 3
Serum free light chains
Serum free light chain assays can detect normal levels of light chains in the blood, as well as elevated levels, even when those levels are undetectable by serum protein electrophoresis and immunofixation. Both free κ and λ chains are measured and the ratio is calculated. Excessive free κ or λ increases the likelihood a of monoclonal plasma cell disorder.
Some evidence suggests that in patients with newly identified MGUS, an abnormal light chain ratio increases the likelihood of progression independent of other factors such as band size and type. However, formal guidelines differ as to the use of serum free light chains in this setting. Recent British Haematology Society guidelines do not recommend their use, other than in patients who are otherwise at higher risk of progression (see “Monitoring monoclonal gammopathy” below) and those where a malignant plasma cell disorder is otherwise clearly suspected.
Serum free light chains are useful in certain specific and uncommon settings, e.g. concern over a possible non-secretory myeloma or amyloidosis, after specialist consultation. Light chains are sometimes used in specialist settings to monitor the response of mutiple myeloma to treatment.
Serum free light chains are not recommended as a first line routine test for plasma cell disorders. There is also no current evidence to support their use in long-term monitoring,9 except for monitoring response of mutiple myeloma to treatment.
Understanding immunoglobulins
Plasma cells produce immunoglobulins which are composed of heavy and light chains. Each plasma cell produces only one type of heavy chain (IgA, IgD, IgG, IgM and IgE) and one type of light chain (either kappa or lambda κ or λ). After the chains are produced they are assembled within the plasma cell to form a whole immunoglobulin.
Overview
Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs.
Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.
Treatment for multiple myeloma isn’t always necessary for people who aren’t experiencing any signs or symptoms. For people with multiple myeloma who require treatment, a number of treatments are available to help control the disease.
Signs and symptoms of multiple myeloma can vary and, early in the disease, there may be none.
When signs and symptoms do occur, they can include:
Bone pain, especially in your spine or chest
Nausea
Constipation
Loss of appetite
Mental fogginess or confusion
Fatigue
Frequent infections
Weight loss
Weakness or numbness in your legs
Excessive thirst
It’s not clear what causes myeloma.
Doctors know that myeloma begins with one abnormal plasma cell in your bone marrow — the soft, blood-producing tissue that fills in the center of most of your bones. The abnormal cell multiplies rapidly.
Because cancer cells don’t mature and then die as normal cells do, they accumulate, eventually overwhelming the production of healthy cells. In the bone marrow, myeloma cells crowd out healthy white blood cells and red blood cells, leading to fatigue and an inability to fight infections.
The myeloma cells continue trying to produce antibodies, as healthy plasma cells do, but the myeloma cells produce abnormal antibodies that the body can’t use. Instead, the abnormal antibodies (monoclonal proteins, or M proteins) build up in the body and cause problems such as damage to the kidneys. Cancer cells can also cause damage to the bones that increases the risk of broken bones.
A connection with MGUS
Multiple myeloma almost always starts out as a relatively benign condition called monoclonal gammopathy of undetermined significance (MGUS).
In the United States, about 3 percent of people older than age 50 have MGUS. Each year, about 1 percent of people with MGUS develop multiple myeloma or a related cancer.
MGUS, like multiple myeloma, is marked by the presence of M proteins — produced by abnormal plasma cells — in your blood. However, in MGUS, the levels of M proteins are lower and no damage to the body occurs.
Risk factors
Factors that may increase your risk of multiple myeloma include:
Increasing age. Your risk of multiple myeloma increases as you age, with most people diagnosed in their mid-60s.
Male sex. Men are more likely to develop the disease than are women.
Black race. Black people are about twice as likely to develop multiple myeloma as are white people.
Family history of multiple myeloma. If a brother, sister or parent has multiple myeloma, you have an increased risk of the disease.
Personal history of a monoclonal gammopathy of undetermined significance (MGUS). Every year 1 percent of the people with MGUS in the United States develop multiple myeloma.
Complications of multiple myeloma include:
Frequent infections. Myeloma cells inhibit your body’s ability to fight infections.
Bone problems. Multiple myeloma can also affect your bones, leading to bone pain, thinning bones and broken bones.
Reduced kidney function. Multiple myeloma may cause problems with kidney function, including kidney failure. Higher calcium levels in the blood related to eroding bones can interfere with your kidneys’ ability to filter your blood’s waste. The proteins produced by the myeloma cells can cause similar problems.
Low red blood cell count (anemia). As myeloma cells crowd out normal blood cells, multiple myeloma can also cause anemia and other blood problems.