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Do you recommend routinely getting periodic 24-hour urine monoclonal protein study for patients with active multiple myeloma?

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Medical Oncology · University of Chicago

In short, no.
I like to perform at the time of diagnosis and then at key points in the patient's journey if it was grossly abnormal (at the time of a bone marrow biopsy, for example).
Patients definitely do not enjoy it. It does allow for IMWG response assessment, which is mandated for patients on t...

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Medical Oncology · University of Texas Health Science Center at San Antonio

Lugging a gallon jug of urine to a clinic visit is the kind of minor indignity that is easy for us to discount, but that can weigh heavily on some patients.

Urine studies are occasionally useful to differentiate light chain cast nephropathy or amyloidosis from other forms of kidney injury. But in ge...

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Medical Oncology · University of Washington, Fred Hutchinson Cancer Research Center

Excellent question - the only addition I'll make to @Dr. First Last's excellent answer is that these tests rarely even change IMWG response criteria either. We've studied this here (ASH abstract below, manuscript under review):

Natsuhara et al., Blood 2022

And hopefully, a registry-based analysis of...

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Medical Oncology · Mayo Clinic Rochester

Completely agree with @Dr. First Last and @Dr. First Last (thanks for that reference).

I have always been curious why it still is included in the response criteria.

The two places where I have found the value of doing the 24hr monoclonal protein:

  1. MM where FLC ratio >100 is the only myeloma defining ev...

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