British Society for Haematology. Listening. Learning. Leading British Society for Haematology. Listening. Learning. Leading
23 July 2018

Urine tests can improve diagnosis of monoclonal gammopathy, according to new findings. 

Dr Gurmukh Singh and colleagues of Augusta University, Georgia, USA, have found evidence that testing urine in addition to blood serum improves diagnostic accuracy.

They explain that the urine test has declined in popularity due to the availability of the new serum free light chain assay. The tests look in either the serum or urine for signs of the abnormal antibody characteristic of the disorder, and to measure the ratio of two types of a portion of the antibody, called light chains.

The team reviewed tests on 175 patients and found that if the patient's disease is associated with the lambda light chain of the antibody, there is about a 25% risk it will not be detected.

Underdetection of the lambda light chains floating in the serum may account for the false negative ratio found in about a quarter of patients who clearly had an abnormal antibody produced by a lambda lesion present in their urine, the investigators report.

Conversely, the ratio can look abnormal in the serum in people who don't have cancer. Dr Singh recommends: "When you test the serum, we suggest you also test the urine whenever you suspect that somebody has a tumour of the plasma cells."


Source: Lee, W.S. and Singh, G., 2018. Serum Free Light Chains in Neoplastic Monoclonal Gammopathies: Relative Under-Detection of Lambda Dominant Kappa/Lambda Ratio, and Underproduction of Free Lambda Light Chains, as Compared to Kappa Light Chains, in Patients With Neoplastic Monoclonal Gammopathies. Journal of clinical medicine research, 10(7), p.562.

Link: http://www.jocmr.org/index.php/JOCMR/article/view/3383

 

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