@A MyMyelomaTeam Member My understanding (and what I learned from my brother's experience), is urine testing is used for some patients to detect Bence-Jones proteins, and more after remission/relapse to gauge the condition, and especially for those that have light chain myeloma, which more often affects the kidneys since they are unable to process the abnormal proteins.

Here's a good explanation from the IMF:

https://www.myeloma.org/types-of-myeloma

"Understanding Light Chains

Approximately 50% of myeloma patients produce free light chains in addition to the complete molecule combination of light chains bound to heavy chains.

Approximately 15%–20% of myeloma patients produce only light chains and no heavy chains. This is called Bence-Jones myeloma, named for the English doctor who first detected and identified light chains, and published his findings in 1848.

Light-chain M-proteins are smaller and weigh less than heavy chains, making it possible for them to fit through the tiny capillaries that send blood to the kidneys. The light chains that arrive by blood to the kidneys may build up to the point of blocking the kidney’s tubules, causing reduced kidney function.

This is why patients with light-chain only myeloma are more likely to have kidney damage or deposits of light chains or on nerves or other organs.

In the majority of patients with light-chain myeloma, their disease can be measured with the sFLC test.

In some patients, their myeloma can be measured only in the urine.

Only 1%–2% of myeloma patients produce very little or no M-protein of any type. These patients may have to be assessed by other means (e.g., imaging, bone marrow testing).

The goal of treatment is to normalize the light-chain levels, especially the ratio, and to eliminate the M-protein. "

*Yet again, another good reason to at least get that baseline bone marrow biopsy, in my humble opinion!*

@A MyMyelomaTeam Member I think that is a great thing your levels were 0!☀️🌻

Mentioned Users

A MyMyelo...

A MyMyelo...

Cheryl,
Thanks for giving us information we don’t always see on the internet.
Paula🌹

Great question @A MyMyelomaTeam Member! Per my latest 24 hour urine PEP, via LabCorp, that number is "Normal between 30-150mg per 24 hour."

From the above MMT answer, shouldn't that be URINE instead of BLOOD? "For MGUS (Monoclonal Gammopathy of Undetermined Significance):
- Blood M protein is less than 30 grams per liter"?

I apologize for hijacking your thread, but I just had mine done and I am more confused than ever. How can I have an above normal 24 hour urine protein, when total urine protein is normal, and there is no evidence of monoclonal protein?

And my urine kappa free light chains and urine k+l ratio are both below low normal? I take that as a good sign, as I don't think it's a good thing to have a high number possibly meaning your kidneys are affected, but I have an abnormally high blood kappa flc and k+l ratio.

protein,total,urine mg/dL was 8.4 Normal; Normal reference: not established.

prot,24HR calculated mg/24 HR was Above High Normal 168. Normal between 30-150.

immunofixation result, urine
COMMENT:
The immunofixation pattern appears unremarkable. Evidence of monoclonal protein is not apparent.

free kappa lt chains,urine, mg/L
Below Low Normal 0.41 (Normal is 1.17- 86.46)

kappa/lambda ratio,Urine
Below Low Normal >0.59. Normal reference: (Phone number can only be seen by the question and answer creators)

Mentioned Users

A MyMyelo...

Thank you so much for helpful info. Cheryl's you mentioned that you remembered something your brother went through. You guys could make a great team!

Cheryl thank you for posting this terrific explanation. 😄