Diagnostic Tests

Diagnostic testing for multiple myeloma is made up of blood tests, urine tests and bone or bone marrow tests. The various types of tests and procedures used to diagnose multiple myeloma include:

Multiple Myeloma Blood tests

Blood cell count
Provide a complete blood count (number of red blood cells, white blood cells, and platelets; and relative proportion of white blood cells). Determines the degree to which multiple myeloma is interfering with the normal production of blood cells. Low levels may signal anemia,increased risk of infection, and poor clotting

Chemistry profile
Measure levels of albumin, calcium, lactate dehydrogenase [LDH], blood urea nitrogen [BUN], and creatinine. Assess function of kidney, liver, and bone status and the extent of disease. Abnormal levels may indicate changes in bone status, liver, or kidney problems. Also indicates the amount of multiple myeloma present.

Beta2-microglobulin (ß2-M) level
Determine the level of a protein that indicates the presence/extent of multiple myeloma and kidney function. Higher levels indicate more extensive disease; aids in staging of disease Antibody (immunoglobulin, or Ig) levels and antibody type (Ig type G or Ig type A).

Determine levels of IgG or IgA antibodies that are overproduced by myeloma cells. Higher levels suggest the presence of multiple myeloma.

Serum protein electrophoresis
Detect the presence and level of various proteins, including the protein made by myeloma cells—Monoclonal or M protein. Higher levels indicate more extensive disease; aids in classification of disease.

Immunofixation electrophoresis (IFE; also called immunoelectrophoresis)
Identify the type of abnormal antibody proteins in the blood. Aids in classification of disease.

Freelite™ serum free light chain assay
Measure antibody light chains made by myeloma cells called kappa or lambda. Abnormal levels and/or ratio suggest the presence of multiple myeloma or a related disease

Urine tests

Urinalysis
Assess kidney function. Abnormal findings may suggest kidney damage

Urine protein level (performed on a 24-hour specimen of urine)
Define the presence and level of Bence Jones proteins (otherwise known as myeloma light chains). Presence indicates multiple myeloma, and higher levels indicate more
extensive disease.

Urine protein electrophoresis
Determine the presence and levels of specific proteins in the urine, including M protein and Bence Jones protein. Presence of M protein or Bence Jones protein indicates multiple myeloma.

Multiple Myeloma Bone/Bone marrow tests

Imaging studies
Bone [skeletal] survey, X-ray, magnetic resonance imaging [MRI], computerized tomography [CT], positron emission tomography [PET]. Assess changes in the bone structure and determine the number and size of tumors in the bone Higher levels of bone changes suggest the presence of multiple myeloma.

Biopsy
On either fluid from the bone marrow or on bone tissue. Determine the number and percentage of normal and cancerous plasma cells in the bone marrow. Presence of myeloma cells confirms the diagnosis. A higher percentage of myeloma cells indicate more extensive disease.

Cytogenetic analysis
(e.g., karyotyping and fluorescence in situ hybridization [FISH])
Assess the number and appearance of chromosomes in order to identify the presence of DNA alterations Certain DNA alterations may indicate how aggressive the disease is