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Tests and diagnosis
By Mayo Clinic staffYour doctor may first detect signs of multiple myeloma before you ever have symptoms — through blood and urine tests conducted during a routine physical exam. If you don't yet have symptoms, these lab tests may be repeated every few months so that your doctor can track whether your disease is progressing and determine the best time to start treatment.
Blood and urine tests
A blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of M proteins, called an "M spike," in your blood. Parts of M proteins may also be detected in a test of your urine — when found in urine, they're referred to as Bence Jones proteins.
If your doctor discovers M proteins, you'll likely need additional blood tests to measure blood cell counts and levels of calcium, uric acid and creatinine. Your doctor may also conduct other blood tests to check for beta2-microglobulin — another protein produced by myeloma cells — or to measure the percent of plasma cells in your bone marrow.
Other tests
You may also need other tests. They may include:
- Imaging. X-rays of your skeleton can show whether your bones have any thinned-out areas, common in multiple myeloma. If a closer view of your bones is necessary, your doctor may use magnetic resonance imaging (MRI), computerized tomography (CT) scanning or positron emission tomography (PET) scanning.
- Bone marrow examination. Your doctor may also conduct a bone marrow examination by using a needle to remove a small sample of bone marrow tissue. The sample is then examined under a microscope to check for myeloma cells.
Staging and classification
These tests can help confirm whether you have multiple myeloma or another condition. If tests indicate you have multiple myeloma, the results from these tests allow your doctor to classify your disease as stage 1, stage 2 or stage 3. People with stage 3 myeloma are more likely to have one or more signs of advanced disease, including greater numbers of myeloma cells and kidney failure.
- Rajkumar SV, et al. Multiple myeloma and related disorders. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/145977116-5/856340478/1709/160.html#4-u1.0-B978-0-443-06694-8..50114-7_4940. Accessed June 12, 2009.
- Konrad CN, et al. Multiple myeloma: Diagnosis and treatment. American Family Physician. 2008;78:853.
- Rajkumar SV. Initial chemotherapy for patients with high risk multiple myeloma. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
- Rajkumar SV. Initial chemotherapy for symptomatic multiple myeloma in patients who are not candidates for transplantation. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
- Treatment of the complications of multiple myeloma. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
- Detailed guide: Multiple myeloma. Chemotherapy and other drugs. American Cancer Society. Accessed June 12, 2009.
- Multiple myeloma: Moving on after treatment. American Cancer Society. Accessed June 12, 2009.
- Richardson PG, et al. Management strategies for relapsed multiple myeloma: Therapy in practice. American Journal of Cancer. 2006;5:393.
- Detailed guide: Multiple myeloma. What are the risk factors for multiple myeloma? American Cancer Society. Accessed June 12, 2009.
- Multiple myeloma: What are some questions I can ask my doctor? American Cancer Society. Accessed June 12, 2009.
- Integrative medicine & complementary and alternative therapies as part of blood cancer care. The Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/attachments/National/br_1150734030.pdf. Accessed June 12, 2009.
- Complementary and alternative methods for cancer management. American Cancer Society. http://www.cancer.org/docroot/ETO/content/ETO_5_1_Introduction.asp. Accessed June 12, 2009.
- Rajkumar SV (expert opinion). Mayo Clinic, Rochester, Minn. July 8, 2008.
