[lrankin]

24-hour urine test - how often?

by lrankin on Mon Apr 24, 2017 7:02 am

My husband has IgA kappa multiple myeloma. The last time he had a 24-hour urine collection was August 2016. How often should he be having a 24-hour urine test?

He is currently on Revlimid for maintenance. He had his autologous stem cell transplant (ASCT) in October 2015 and started main­te­nance March 2016.

His bloodwork has been good, but I just noticed he hasn't had a 24-hour urine test since August 2016. I think that, with his type of multiple myeloma, shouldn't he be having the test often?

[Multibilly]

Re: 24-hour urine test - how often?

by Multibilly on Mon Apr 24, 2017 1:34 pm

As always, I'm not a doctor and I've never received treatment. But if you can track the disease response via his total IgA level (M-spike measurements in people with IgA multiple myeloma can be a bit unreliable) and serum free light chain numbers, why bother with routine 24 hour UPEPs at this stage? Yes, you do still technically need a 24-hour UPEP to establish the level of response (stringent complete response, complete response, etc) per the IMWG criteria. But it doesn't seem as critical to me to be routinely monitoring UPEP levels if you are on top of the serum numbers and those serum numbers are doing well in the maintenance phase. But again, I'm not a doctor.

So, maybe get a UPEP once a year if the serum numbers are doing well and to make you fee more comfortable, or when there is a significant change his his serum numbers?

Lastly, if I had IgA-type multiple myeloma, I would be more interested in having my doctor track me via HevyLite testing since M-spike tracking in IgA patients can be problematic. In the USA, Labcorp now offers HevyLite testing (link).

Somebody else that is actually on maintenance may have a different opinion on this matter.