[3334]

24-hour versus random UPEP

by 3334 on Wed Mar 11, 2015 1:26 pm

Are random UPEP tests as accurate as a 24-hour UPEP, or should only 24 hour urine testing be done?

Should a 24-hour urine im­muno­fix­ation also be done routinely to measure urine im­muno­glob­u­lins levels if they are also present in large quantities?

[Dr. Adam Cohen]

Re: 24-hour versus random UPEP

by Dr. Adam Cohen on Wed Mar 11, 2015 7:23 pm

In general, a 24-hour urine PEP (UPEP) is considered more accurate than a random UPEP, and is actually required (according to the International Myeloma Working Group) if the urine M-spike is being used to determined a patient's response to therapy.

The urine immunofixation tells the type of myeloma protein that is being secreted into the urine. It is needed at diagnosis, and then becomes important again if the UPEP and SPEP become nega­tive and you want to know if a patient has achieved a complete response (CR). To get a CR, the SPEP, 24 hour UPEP, serum immunofixation, and 24 hour urine immunofixation must all be nega­tive, and the bone marrow must have <5% plasma cells.

Hope this is helpful.

[3334]

Re: 24-hour versus random UPEP

by 3334 on Wed Mar 11, 2015 9:15 pm

Dr. Cohen, your explanation was so helpful in understanding why and which tests are nec­es­sary to check response of therapy. After a repeat bone marrow biopsy, I start Revlimid, Vel­cade, and dexamethasone (RVD) for 2-4 months then a stem cell transplant (SCT) for multiple myeloma and AL amyloidosis. Monthly quantitative urine tests for light chains and m-spike along with the serum tests were discussed, but I forgot to ask if the urine tests would be random or 24 hour. Thanks so much!