Kappa/Lambda Question

[Waves01]

Met with a new haematologist yesterday to discuss my SLL diagnosis and I was hit with a myeloma potential diagnosis as well because I had a lambda <1% which he wants to monitor. My kappa was 83%. Not what I expected and had never been mentioned. Has anyone had similar conversation ? Thanks

[Jm954 Administrator]

Both myeloma and CLL are B cell disorders that are characterised by something called light chain restriction. This basically means that the CLL and myeloma cells all produce the same light chains, either kappa or lambda to excess. This is because they are clonal disease, all arising from the same malignant cell. Myeloma patients usually also have high levels of immunoglobulin which is produced by the myeloma cells and not helpful in fighting infections.CLL and SLL patients can sometimes have low levels of excess light chains but myeloma patients typically see very high levels. There are other ways of differentiating between myeloma and CLL though, including flow cytometry but you may need a bone marrow test at some point.

Hope this helps.

[Waves01 in reply to Jm954]

Thank you. I’ve had a bone marrow biopsy. What would that show re myeloma?

[Jm954 Administrator in reply to Waves01]

Yes, it should do but it can be patchy in the marrow.

A full body X-ray, called a skeletal survey is sometimes helpful as it can show up the patches of myeloma in your bones.If you do have both then the treatment is very different for each. However, like CLL, myeloma can be indolent for quite a while before treatment is needed.

All the very best

Jackie