title: High incidence of intact or fragmented immunoglobulin in urine of patients with multiple myeloma.
abstract: In this prospective study we determined the incidence of intact/fragmented immunoglobulin and Bence Jones protein in urine immunofixation using Sebia reagents and HydrasysTM 2 apparatus and compared the results to concentrations of serum free light chains (FLC) assessed using Siemens BNTM II nephelometer and the immunoassay Freelite (Binding Site) in 289 patients with multiple myeloma at diagnosis. It was found that in one third of IgG, IgA and IgD myeloma patients, intact/fragmented immunoglobulin can be detected in urine and is connected with impaired renal function and reduced survival. Urine immunofixation detects monoclonal protein (FLC and intact/fragmented immunoglobulin) in 66-79% of IgG and IgA myeloma patients while serum FLC immunoassay detect it in 82-94% of IgG and IgA myeloma patients. However, the latter method is inadequate for detection of intact/fragmented immunoglobulin in urine. Serum FLC immunoassay and urine immunofixation are complementary methods in diagnosing and monitoring monoclonal protein in patients with myeloma.
authors: a Department of Diagnostics for Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors: Maria
authors: M
authors: Kraj
authors: a Department of Diagnostics for Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors: Barbara
authors: B
authors: Kruk
authors: b Department of Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.|c Department of Hematology and Transfusion Medicine , Centre of Postgraduate Medical Education , Warsaw , Poland.
authors: Ewa
authors: E
authors: Lech-Marańda
authors: b Department of Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors: Krzysztof
authors: K
authors: Warzocha
authors: a Department of Diagnostics for Hematology , Institute of Hematology and Transfusion Medicine , Warsaw , Poland.
authors: Monika
authors: M
authors: Prochorec-Sobieszek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007128:Immunoglobulin Fragments / Q000097:blood / Q000652:urine*; D007132:Immunoglobulin Isotypes / Q000097:blood / Q000652:urine; D007147:Immunoglobulin Light Chains / Q000097:blood / Q000652:urine; D007136:Immunoglobulins / Q000097:blood / Q000652:urine*; D015994:Incidence; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000652:urine*; D009367:Neoplasm Staging; D011507:Proteinuria / Q000453:epidemiology* / Q000209:etiology*; D016019:Survival Analysis
chemical_list: D007128:Immunoglobulin Fragments; D007132:Immunoglobulin Isotypes; D007147:Immunoglobulin Light Chains; D007136:Immunoglobulins
keywords: Free light chains; intact immunoglobulin; multiple myeloma; urine immunoglobulin