Sorry- no idea about Apherisis or why only his Kappa is high when everything else is good.

I’d try using another Lab like Labcorp to verify these numbers. Something doesn’t make sense.

I do know that a bad Blood Draw can cause a very high False LDH level. Basically the blood cells are being damaged due to the bad Draw

From Perplexity AI Deep Research:

“**A difficult blood draw can make a kappa free-light-chain result unreliable if it causes substantial hemolysis—but not because damaged red blood cells release kappa.** Unlike LDH, kappa free light chains are not stored in red cells; any false change would come from **optical/analytical interference in the assay**, and whether that occurs depends strongly on the laboratory’s analyzer and method.[1][2][3]

## Why the method matters

Results differ among assay platforms:

- One FDA-reviewed FREELITE method showed no significant interference at hemoglobin concentrations up to 5 g/L.[1]
- Another FREELITE platform showed interference at hemoglobin concentrations of 3 mg/mL or higher.[2]
- The Optilite FREELITE kappa assay is specifically described as unsuitable for hemolyzed specimens.[3]
- Accordingly, Mayo accepts grossly hemolyzed specimens for its current method, while Quest and Labcorp reject them.[4][5][6]

Therefore, hemolysis **cannot automatically be assumed to produce a falsely high kappa**. Depending on the assay, it might have little effect or cause an unpredictable error—not necessarily an upward one.

## Interpreting high kappa

The absolute kappa number should be considered with:

- **Lambda and the kappa:lambda ratio**
- **Creatinine and eGFR**
- **Involved-minus-uninvolved FLC difference**
- **SPEP and serum immunofixation**
- **Previous results from the same laboratory**

If kappa and lambda are both elevated but the ratio remains appropriate, impaired kidney clearance, inflammation, or polyclonal immune activation may explain the elevation. Kidney function can materially affect FLC concentrations. A selectively rising kappa accompanied by an increasingly abnormal ratio is more concerning than an isolated absolute kappa elevation.[7][8][9]

## Best next step

Ask the laboratory whether the sample had an elevated **hemolysis index** and whether that exceeded the validated limit for its particular FLC assay. If the kappa result is unexpected—especially if LDH, potassium, or AST also appeared unexpectedly high—the cleanest way to resolve the question is to **repeat kappa, lambda, and the ratio on a nonhemolyzed specimen, preferably using the same laboratory and method**.

Normal SPEP or immunofixation is reassuring but does not necessarily make an abnormal FLC pattern irrelevant, particularly in light-chain or oligosecretory myeloma. The treating hematologist should therefore compare the repeat result with kidney function and the longitudinal trend rather than dismissing it solely as a bad draw.[8][7]”

I agree on repeating the blood test.

Thanks for the information.
Larry, 8708 was the Kappa in Jan 2026 (now 901 from a low of 379 in July 2026)
The following are numbers at start (Jan 26 first number) and (Oct 26 second number)
IgM 14 18
IgA 51 99
IgG 771 722

Other from 10/26
ALT 15
AST 21
BUN 15
Creatinine .92
WBC 5.0
RBC 4.18
Hemog 13.4

Everythink looks good except the Kappa going back up. Do you know of anyone that has used Apheresis to get rid of Kappa? Sounds interesting.

He doesn't need to zap myeloma quickly - We're thinking of just a low, low amount of meds to keep it at bay and still feel good.

Thanks everyone

Cynthia if Kappa is going up that could signal active MM and no longer in remission. But yeah, I would try the lower dosage first that he tolerated to see if it brings it under control. You have to be your own advocate in your treatments as much as possible after all it is your life you are talking about.

Cynthia,
The Multiple Myeloma Research Foundation always recommends a second opinion when treatment needs to be started again. They have a list of MM Specialists that can help with the second opinion. Your Oncologist will appreciate the feedback from another colleague.
HTTPS://www.themmrf.org
Quality of Life is important, and you make the decision, after hearing what the doctor says.
Paula🌹

The MMRF | Multiple Myeloma Research Foundation

https://www.themmrf.org