Diagnosing Myeloma? Don’t Skip This Critical Amyloidosis Test! Jahanzaib Khwaja, MD, FRCPath

So my name is Johan Zakwaja. I am a haematologist in the UK at the University College London Hospitals and the National Aminoidosis Centre. So for myeloma patients at diagnosis, it's really important to look at a number of tests because we know that systemic AL aminoidosis is rare and it's not really identified unless we are active about looking for it. So we look at the free light chains, so that's your lambda and your kappa light chains, which is I think a standard test that myeloma doctors will do. Another test that's really important is the 24-hour urine protein as well as BJP measurements. And the reason why that's really important in the amyloid setting is because even though there may be a really small burden of disease with the light chains not being really highly elevated, you can have problems in the kidneys that we'll only be able to pick up with these sensitive tests with the 24-hour urine protein measurements. And it's certainly important to measure at diagnosis because then we can really screen for which patients will have that. I think it's also important to look for heart markers. And again, similarly, because if we're not looking for it, then we're going to miss out on diagnoses. And the reason why that's important is because there are really effective treatments and unless we diagnose it, we won't be treating patients adequately.