How Is Multiple Myeloma Diagnosed?

All Myeloma is Not the Same

Did you know that not all myeloma is the same? There are several subtypes, with some forms being more aggressive and others less so. Identifying your myeloma subtype through specific tests is key to determining the best treatment plan.

An Accurate Multiple Myeloma Diagnosis

A single test result is not enough to diagnose multiple myeloma. Diagnosis relies on a combination of factors, including your symptoms, a physical examination by your doctor, and the results of multiple tests.

To confirm a multiple myeloma diagnosis, one of the following must be present:

• A plasma cell tumor confirmed by biopsy
• At least 10% plasma cells in the bone marrow

AND one of the following:

• M protein in the blood above 3g/dL
• M protein in the urine above 1g/dL
• Holes in the bones (lytic lesions) visible on imaging scans

Smoldering Myeloma

Smoldering myeloma refers to early-stage myeloma that isn’t yet causing symptoms or complications. People with smoldering myeloma have normal blood counts, calcium levels, kidney function, and no bone or organ damage.

Laboratory Tests

If you show symptoms of multiple myeloma, your doctor will likely recommend a combination of tests, including blood and urine tests, x-rays, and a bone marrow biopsy.

Complete Blood Count (CBC)

This test measures your red cells, white cells, and platelets. If myeloma cells are crowding out your bone marrow, you might experience anemia and low counts of white cells and platelets.

Quantitative Immunoglobulins

This test checks the levels of different antibodies (immunoglobulins) in your blood, such as IgA, IgD, IgE, IgG, and IgM. In multiple myeloma, one type of antibody can grow out of control, crowding out the others and making you more prone to infections.

Electrophoresis Tests (SPEP and UPEP)

These tests detect abnormal immunoglobulins, or M-proteins, produced by myeloma cells. SPEP looks for M-proteins in the blood, while UPEP checks the urine. Finding an abnormal M-protein can be a key step in diagnosing multiple myeloma.

Free Light Chains

This blood test measures light chains, fragments of immunoglobulins that can be overproduced in myeloma. It’s particularly useful when no M-protein is detected by other tests.

Beta-2 Microglobulin

This protein, produced by myeloma cells, is a marker of disease aggressiveness. Higher levels indicate a more aggressive form of myeloma.

Bone Marrow Biopsy

A bone marrow biopsy is an important test to see if myeloma cells are present in the bone marrow. This procedure is performed using a needle to extract a small sample of bone marrow, typically from the pelvic bone. While it may cause brief discomfort, it is usually done with local anesthesia, and some patients opt for light sedation.

Advanced Testing

Additional tests like immunohistochemistry, flow cytometry, and cytogenetics can help identify specific characteristics of the myeloma cells. These tests can provide important information about your prognosis and guide personalized treatment.

Imaging Tests

Bone x-rays, CT scans, MRIs, and PET scans are used to detect bone damage or tumors caused by myeloma. These imaging studies provide a detailed view of the bones and other organs to check for signs of disease spread.

Learn More about Myeloma Testing 

Multiple myeloma specialists, interviewed by our team at HealthTree University, share the diagnostic tests necessary to detect and classify multiple myeloma.

Track Your Myeloma Labs

It can be extremely overwhelming to view all the lab and test results given to you at your various doctor's appointments. Let us help you see all of your labs in one place and track your results from the multiple myeloma tests. Join HealthTree Cure Hub today and securely upload your electronic health records to get started. 

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