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A series of studies, principally from the Mayo Clinic, have indicated that patients with an abnormal free kappa to free lambda ratio have an increased risk of progression to active myeloma from precursor conditions including monoclonal gammopathy of undetermined significance (MGUS), [32] [33] smouldering myeloma [34] and solitary plasmacytoma ...
Once set, light chain class remains fixed for the life of the B lymphocyte. In a healthy individual, the total kappa-to-lambda ratio is roughly 2:1 in serum (measuring intact whole antibodies) or 1:1.5 if measuring free light chains, with a highly divergent ratio indicative of neoplasm. The free light chain ratio ranges from 0.26 to 1.65. [1]
[70] [79] These biomarkers are >60% clonal plasma cells, a serum involved / uninvolved free light chain ratio ≥ 100 (the concentration of the involved free light chain must be ≥ 100 mg/L) and more than one focal lesion ≥ 5 mm by MRI. [70] [79] Together, these biomarkers and the CRAB criteria are known as myeloma-defining events (MDEs).
Light chain MGUS is defined as a disorder in which a serum κ to λ free light chain ratio falls outside the normal range of 0.26–1.65 (mean =0.9) provided that it is not associated with: a) any of the CRAB criteria, b) a bone marrow plasma cell count of 10 or a higher percentage of nucleated cells, c) evidence of amyloid deposition (see ...
A reference range is usually defined as the set of values 95 percent of the ... which is approximately 60–100% larger than the ... kappa/lambda ratio: 0.26 [169] 1.65
Quantification is important for disease classification and for disease monitoring once a patient has been treated (increased skewing of the ratio between kappa and lambda light chains after a patient has been treated is an indication of disease recurrence).
DALLAS, TEXAS - JULY 10: U.S. Vice President Kamala Harris speaks to Alpha Kappa Alpha Sorority members at the Kay Bailey Hutchison Convention Center on July 10, 2024 in Dallas, Texas.
Kappa/lambda in-situ hybridization is another diagnostic test that needs to be done when trying to characterize the lesion for further confirmation. [3] Common results associated with kappa/lambda in-situ hybridization studies of PCGs are an abundant population of CD138 positive polyclonal plasma cells. [ 3 ]