Hi, I have just been diagnosed with Kappa Light Chain Monoclonal gammopathy of unknown significance (MGUS). My Kappa levels are 178 and my Kappa:Lambda ratio is 18.5. In addition I have immunoparesis with both my IgG and IgM levels just below the bottom of the normal range. I understand that a ratio of 20 is one of the criteria for Smouldering Multiple Myeloma. My question is, should I have been offered a bone marrow biopsy as my ratio of 18.5 is so close to 20, particularly with the immunoparesis? I am due to be seen by the consultant at the end of December to discuss the results of follow up blood tests. Assuming the levels haven’t changed much by then, should I ask for a bone marrow biopsy?
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Hi there I’m going to link you to myeloma uk
The Monoclonal gammopathy of unknown significance (MGUS) diary may also be useful
You allowed to ask any questions of your consultant and your consultant will know if you need a bone marrow biopsy.
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Hello there @CaptainKappa, and welcome to the forum. I’m glad you found us, though I’m sorry you’re having to grapple with all of this uncertainty.
I’m going to loop in our @BloodCancerUK_Nurses here, as they may be able to offer insight into how these thresholds are usually interpreted in practice, what that means in terms of a bone marrow biopsy, and how people often approach conversations like this with their consultant.
In the meantime, you’re very welcome to keep posting here if more questions come up as you process everything.
Take care,
Ceri - Blood Cancer UK Support Services
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Dear @CaptainKappa ,
Welcome to our forum. I am sorry to read about your recent diagnosis of Kappa Light Chain Monoclonal Gammopathy of Undetermined Significance. If it would be helpful to talk things through in more detail, please do hesitant to contact the haematology support nurses on 0808 2080 888
Bone marrow biopsies are not routinely required for a diagnosis of Monoclonal gammopathy of unknown significance (MGUS), this however can depend on many factors including your risk factor and other blood abnormalities including anaemia, having raised calcium levels in the blood and renal impairment. Also, symptoms including bone pain, recurrent infections and generally feeling unwell.
You will not necessarily have been offered a bone marrow biopsy and I suspected as you are being followed up within 3 months, your consultant may want to review the results of any other blood tests first. It is absolutely fine to ask your consultant if you need a bone marrow biopsy, and any concerns that you may have. They will have all your medical records and will be able to discuss in more detail with you. This is a common question asked by patients and one that is completely justified.
Kind regards
Fiona (support services nurse)
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