How Doctors Detect Multiple Myeloma

Reviewed medically by Archana Sharma, DO

Diagnosing multiple myeloma , known as myeloma, typically involves a complicated procedure. Although this uncommon type of blood cancer may lead to various issues, it cannot be diagnosed through one laboratory test alone.

Jump to Key Takeaways .

Laboratory Tests

Complete blood count (CBC): A complete blood count (CBC) assesses general blood health. It measures the levels of red blood cells, white blood cells, and platelets because these counts may decrease in multiple myeloma as abnormal plasma cells displace healthy ones.
Blood chemistry profile: This laboratory test assists in evaluating the condition of your kidneys and liver, identifies signs of bone damage associated with myeloma, and assesses how far the illness has progressed by checking concentrations of albumin, calcium, and blood urea nitrogen (BUN), creatinine , and lactate dehydrogenase (LDH) in your blood.
Quantitative immunoglobulins Antibodies, also known as immunoglobulins (Igs), are substances created by cells within the immune system. These include IgA, IgG, IgM, IgD, and IgE. Monitoring the quantities and varieties of antibodies that are excessively generated by myeloma cells can aid in identifying myeloma.
Electrophoresis This examination can be conducted using blood or urine specimens to detect monoclonal proteins or M proteins, which are atypical antibodies created by myeloma cells. Elevated amounts of M proteins may suggest the presence of myeloma. Different versions of this test include: Serum protein electrophoresis (SPEP) This examination identifies monclonal antibodies within your bloodstream; Immunofixation or immunoelectrophoresis This laboratory test detects the particular kind of M protein present in your bloodstream; Urinary protein electrophoresis (UPEP) and urinary immunofixation: These examinations recognize and determine unusual proteins known as Bence Jones proteins, which are fragments of atypical M protein that pass through your kidneys and appear in your urine.
Serum free light chain This examination detects minute fragments of atypical proteins known as serum-free light chains within your bloodstream.

Bone Marrow Studies

Bone marrow tests are conducted to determine the amount of myeloma cells present in a bone marrow sample (the soft, sponge-like material located within bones), typically obtained from your hipbone using a lengthy needle through the following methods:

Bone marrow biopsy This process involves taking a tiny fragment of bone to analyze the bone marrow.
Bone marrow aspiration This process involves taking a tiny quantity of liquid bone marrow to analyze the cells found within the bone marrow.

Cancerous plasma cells found in your bone marrow can also be utilized for the following kinds of tests:

Fluorescence in situ hybridization (FISH) This examination employs fluorescent dyes that specifically bind to particular regions of a chromosome. It has the capability to identify genetic disorders, classify conditions as low- or high-risk, and assist in determining appropriate therapeutic approaches.
Karyotyping This examination evaluates the structure, dimensions, and count of chromosomes within the bone marrow.
Genome sequencing This examination analyzes the genetic material of specific myeloma cells to assist your medical care providers in gaining insight into your condition and potential responses to particular therapies.

Imaging Studies

When multiple myeloma advances, it creates tiny cavities called lytic lesions within the bones. Diagnostic imaging techniques help detect and assess the number and dimensions of these affected regions. These same imaging methods can also examine alterations in bone structure that suggest the presence of multiple myeloma.

Imaging tests employed for diagnosing, determining the stage, and preparing treatment strategies for multiple myeloma include:

X-rays Bone x-rays can detect bone injury resulting from myeloma cells, although additional imaging methods may offer clearer images.
Computed tomography (CT) scan A computed tomography (CT) scan uses X-ray beams from multiple directions to produce high-resolution pictures of the internal structures of your body. This procedure can assist in identifying if myeloma has caused harm to your bones.
Magnetic Resonance Imaging (MRI) examination Imaging test using magnetic resonance technology Scan employing magnetic resonance techniques Medical imaging procedure utilizing MRI Non-invasive diagnostic technique with MRI Radiological assessment through magnetic resonance scanning Diagnostic imaging method based on MRI principles Procedure for generating detailed internal body images via MRI Technique involving magnetic fields and radio waves for medical imaging Scanning process using magnetic resonance to visualize bodily structures An MRI employs radio waves and strong magnetic fields to generate detailed pictures of your body's internal soft tissues, avoiding the use of x-rays found in CT scans.
Positive electron emission tomography (PET) scan A PET scan requires administering a small amount of radioactive glucose through a vein. Once inside the body, this substance is taken up by cancerous cells, making hidden tumors visible that cannot be detected using regular X-ray imaging. This procedure is frequently paired with a CT scan, resulting in what is known as a PET/CT scan.

Diagnostic Criteria

As stated by the International Myeloma Working Group (IMWG), multiple myeloma is identified when the following conditions are met:

At least 10% of clonal plasma cells found in the bone marrow or a confirmed plasma cell tumor through biopsy
Furthermore, one or more of the following: Hypercalcemia (high blood calcium), renal failure impaired kidney function, anemia (decreased number of red blood cells), areas of bone destruction, 60% or higher percentage of plasma cells in the bone marrow, elevated levels of a single type of light chain in the bloodstream such that one type is at least 100 times more prevalent than the other, or multiple small lesions (focal spots) visible on an MRI

Key Takeaways

Diagnosing multiple myeloma requires an integrated method that includes patient assessment, lab examinations, radiological scans, and genetic testing.
Although identifying multiple myeloma can be challenging, improvements in technology and updated diagnostic standards help enhance the care and therapy of the condition.
If you are vulnerable to multiple myeloma or experiencing related symptoms, speak to a medical professional to facilitate timely detection.

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