Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1012 page)

   
Normal range:

   Free kappa: 3.30–19.40 mg/L

   Free lambda: 5.71–26.30 mg/L

   Kappa/lambda ratio: 0.26–1.65

   Use

   Diagnosis and monitoring progress of patients with nonsecretory myeloma and oligosecretory (<1 g/dL monoclonal protein in the serum and <200 mg/ day monoclonal protein in the urine) myeloma

   Diagnosis and monitoring progress of patients with light chain myeloma as well as primary systemic amyloidosis, in whom the underlying clonal plasma cell disorder may otherwise be difficult to detect and monitor

   Predicting risk of progression of MGUS

   Predicting risk of progression of solitary bone plasmacytoma

   Diagnosis, monitoring during and after treatment, and perhaps prognosis of patients with multiple myeloma and an intact immunoglobulin

   Interpretation (Table 16.45)

Increased In (see Limitations)

   Multiple myeloma

   Lymphocytic neoplasms