[blair77]

Testing for Bence Jones protein - how often?

by blair77 on Tue Dec 16, 2014 12:22 am

How often do most patients have a 24 hour urine test for Bence Jones protein? Also, can the serum free light chain test replace the urine test?

[Multibilly]

Re: Testing for Bence Jones protein - how often?

by Multibilly on Tue Dec 16, 2014 8:15 am

Hi Blair,

See this thread where I was wondering the same thing:

"24 hour UPEP and free light chain (FLC) half life," Beacon forum discussion started Jul 8, 2014

In my case, my doc doesn't really see any value in using a UPEP for monitoring my SMM disease. I was the one that actually asked him to order a UPEP about a year ago, which I've only done once or twice. But note that Dr. Shah makes a case for the utility of the UPEP in the above link.

[juliofrippo]

Re: Testing for Bence Jones protein - how often?

by juliofrippo on Sun Dec 21, 2014 1:58 pm

Just a couple of ob­ser­va­tions from my own ex­per­i­ence with multiple myeloma.

1. I had a BMT at the Mayo Clinic, Rochester, MN about 18 months ago. It was a complete success and I have been in remission since that time. My latest 6 month follow up at my local cancer clinic indicated that my blood work was normal, but my UPEP indicated a spike in protein. In addition, I have noticed an increase in the amount of thick foam when I urinate. This seems to indicate that a UPEP along with the blood work are both valuable tests when dealing with multiple myeloma. I am now in the process of doing a followup 24 hour urine test.
    
2. As far as the need to refrigerate the urine collected, Mayo does not require it, while my local clinic does. Two different containers are used, so I assume one of them has some kind of chemical coating that prevents degrading. Needless to say, the one not requiring refrigeration is a lot more "user" friendly.

[blair77]

Re: Testing for Bence Jones protein - how often?

by blair77 on Mon Dec 22, 2014 3:06 am

Thanks guys! My husband's IgA is elevated, but all his other myeloma markers are negative (SPEP, IFE they have been negative 2 times in a row since his IgA has risen above the norm, and light chains and ratio continue to be in range and normal). His latest BMB was inconclusive because his plasma cells were slightly increased 5-10%, but did not show clonality.

I read that Revlimid maintenance can cause an elevated IgA and plasmacytosis, so I'm wondering if this could be the case. However, in the study I read, all the patients had IgG myeloma, not IgA.

Anyway, they haven't done a UPEP in about 6 months and I'm wondering if it might show if the myeloma is resurfacing and causing this total IgA to be above the ULN, since all the other available tests seem to be inconclusive.

[BeatMyeloma]

Re: Testing for Bence Jones protein - how often?

by BeatMyeloma on Mon Dec 22, 2014 11:14 am

Hi blair77! My mother has IgA myeloma and also is dealing with elevated IgA on recently started RVD [Revlimid, Velcade, dex], but her other numbers / markers are generally good.

Best of luck to you!

[blair77]

Re: Testing for Bence Jones protein - how often?

by blair77 on Mon Dec 22, 2014 9:08 pm

Hi Beatmyeloma,

So, is your mother also having a 0 M-spike and a negative IFE? My husband's PET scan was also negative. His doctor said an elevated IgA was not a reason to restart treatment.

What was the basis of them restarting your mom's treatment?

[BeatMyeloma]

Re: Testing for Bence Jones protein - how often?

by BeatMyeloma on Tue Dec 23, 2014 12:23 pm

Hi blair77,

My mother actually doesn't have a M-spike. And not in a complete remission way! (Unfortunately.)

Her doctor told her that, with IgA myeloma, the IgA is a much better marker to track for her. Mom's PET scan isn't clear. After a 5-year complete remission with no maintenance, they found a plas­ma­cy­toma in her uterus a year ago.

In her case, it seems like the IgA seems to be triggered by this plasmacytoma.