As I understand: The M-Protein is a large molecule, too large to pass from the bone marrow into the blood stream. The kappa and lambda are smaller proteins that break off of the larger M-Protein. They are small enough to pass into the bloodstream. That's why they are called "light chains". I think it's generally true of both them, but the kappa protein can lodge itself in the tissue of various organs, starting, it would seem, in the organs of the urinary system, causing renal failure.
Question: Have you had a bone marrow biopsy? That, again as I understand all of this, is what really determines how severe your condition is, be it MGUS, smoldering myeloma, or full blown multiple myeloma.
One exception to that is whether you are anemic or not, assuming there are other indications of myeloma showing up in various tests. indications of some form or degree of myeloma. If there are, and your are anemic, then you have multiple myeloma. It has affected your bone marrow to the point that it cannot produce enough of the red blood cells your body needs.
Much more could be said, and I could be misinformed. Nevertheless, I agree with the others; your hemotologist/oncologist seems to be less informed than he should be -- less informed that you need him to be. I would seek out an MM specialist.
Let me add this: as part of a whole battery of tests, your M-Spike is a very important number. In conjuntion with kappa and lambda light chain numbers, it can show whether or not your MM is being adequately controlled.
Personally, I think the bone marrow biopsy is very important. It can at least confirm what other tests are showing.

https://healthtree.org/

HealthTree

https://healthtree.org/

Mildred, Duke is a great hospital. I have no idea regarding your numbers but from what I can make of it you have IgG myeloma. Your numbers sure reflect more to me than MGUS. You need to see a myeloma specialist. Ask to be referred to a myeloma specialist going forward. I’m hoping you will be fine but do not mess around. Myeloma is complex and early intervention is absolutely necessary. Godspeed.

There are a couple of resources I found very helpful. The Multiple Myeloma Researce Foundation (MMRF) is an excellent resource. I’ve also found it helpful to plug in test results to ChatGPT to get a better understanding. Both of those are helpful, but the group is correct. Find a MM specialist to oversee your treatment and answer your questions. Go with a list of questions and with a helper to assist in remembering the answers. I choose to go to MD Anderson in Houston TX because of their great MM group. We live in NC so there was travel expenses which are tax deductible if you keep records. Good luck and God bless in your journey.

Thanks Angie I did get in contact with them. When they call me back i will inform you about what they say.