blood disorders
Multiple Myeloma
Diagnosis of Multiple Myeloma
Laboratory tests Bone marrow biopsy X-rays or other imaging studies (magnetic resonance imaging, and positron emission tomography combined with computed tomography) Multiple myeloma may be discovered even before people have symptoms, when laboratory tests done for another reason show elevated protein levels in the blood or protein in the urine, or an x-ray done for another reason shows specific areas of bone loss. Bone loss may be widespread or, more often, appears as isolated punched-out areas in bones. Multiple myeloma is sometimes suspected because of symptoms, such as back pain or bone pain in other sites, fatigue, fevers, and bruising. Blood tests done to investigate such symptoms may reveal that a person has Overview of Anemia , The most useful laboratory tests are protein electrophoresis and immunoelectrophoresis of serum and urine. They detect and identify an overabundance of a single type of antibody found in most people who have multiple myeloma. Doctors also measure the different types of antibodies, especially IgG and IgA. IgM, IgD, and particularly IgE types of multiple myeloma are rare. Calcium levels are usually measured as well. A urine specimen collected over a 24-hour period is analyzed for the amount and types of protein in it. Bence Jones proteins, which represent part of the monoclonal antibody, are found in the urine of half of the people who have multiple myeloma. A Bone Marrow Examination is done to confirm the diagnosis. In people with multiple myeloma, bone marrow specimens show a large number of plasma cells abnormally arranged in sheets and clusters. Individual cells also may appear abnormal. In addition, other blood tests are useful in determining how advanced multiple myeloma is (staging). Certain changes in levels of specific protein (eg, higher levels of beta-2 microglobulin and lower levels ofalbumin) in the person's blood when the disease is diagnosed usually indicate the likelihood of a shortened survival and are likely to affect treatment decisions. In addition, specific chromosomal abnormalities and higher serum lactate dehydrogenase levels predict shortened survival. Even if x-ray findings suggest the diagnosis, imaging is needed to determine what bones are affected. X-rays of the entire body (skeletal survey) are usually done. Magnetic resonance imaging (MRI) or positron emission tomography (PET) combined with computed tomography (CT) may also be done to examine specific sites of bone pain. 