A recent study published by Dr Natsuhara et al. 1, which included 281 patients over 3 years following start of therapy, suggests that “24-hour urine testing may add little value to response assessment criteria for patients with MM who have other markers of measurable disease (and in the absence of AL amyloidosis)”.
Another study presented at the International Myeloma Society 2023 meeting 2, retrospectively analyzed data from 841 patients over 10 years and suggests that “24-hour urine can be replaced by serum free light chains (sFLC) for response and progression” in Multiple Myeloma treatment monitoring. In addition, the authors noticed that in 13% of patients who progressed, sFLC were the only marker of progression, enhancing their value over urine analysis.
Enable more frequent and convenient monitoring of Multiple Myeloma patients
Monthly urine protein electrophoresis (UPE) testing is recommended alongside serum testing in the IMWG guidelines for monitoring Multiple Myeloma (MM) patients during active treatment 3. However, a study by Foster et al., 4 demonstrated 24-hour urine tests are not consistently used in clinical practice, with only 27.7% of Multiple Myeloma and 15.2% of Light Chain Multiple Myeloma patients being followed by UPE, compared to 58.1% and 84.8% with serum free light chains (sFLC) respectively. Practical issues around the collection, storage and processing of 24-hour urine samples hinders their application in real-world settings.
Multiple Myeloma patients being monitored with sFLC were able to be tested more than twice as often than those by UPE. Patients monitored with sFLC tests had an average time between tests of 42 days for sFLC compared to 95 days for UPE.
Find out more about the benefits of serum free light chain testing compared to urine testing:
References:
1. Natsuhara KH, Huang CY, Knoche J, Arora S, Chung A, Martin T, et al. Significance of the pee-value: relevance of 24-hour urine studies for patients with myeloma. Leuk Lymphoma 2023 Apr 25:1-8. Epub 20230425 as doi: 10.1080/10428194.2023.2201365.
2. Askari E. Adding value of serum-free light chain in assessing response and progression in multiple myeloma with measurable disease. Presented at IMS 2023:P-126a.
3. Ludwig H, Miguel JS, Dimopoulos MA, Palumbo A, Garcia SR, Powles R, et al. International Myeloma Working Group recommendations for global myeloma care. Leukemia 2014 10/9/2013;28:5:981-92 as doi: leu2013293 [pii];10.1038/leu.2013.293 [doi].
4. Foster RB, Tromanhauser M, Gayer C, Gonzales PK, Maignan K, Opong AS, et al. Approximating International Myeloma Working Group Uniform Response Criteria to Derive Response for Multiple Myeloma (MM) Patients Using Data from Electronic Health Records (EHR). Presented at ASH 2019 2019/11/13/;134:4727 as doi: https://doi.org/10.1182/blood-2019-127181.