What testing should be done to confirm a myeloma diagnosis?

[Music] what testing should be done to confirm a myeloma diagnosis to confirm a myeloma diagnosis we need to do a battery of tests these include blood tests urine tests tests on the bone marrow and also imaging tests these give us a variety of information both to help diagnose the disease and to establish the aggressiveness of the disease it also has starting to have implications on what treatments we decide to give our patients so as far as the blood tests go we do a complete blood count looking mainly for the hemoglobin level we do chemistry tests to look at the kidney function also to look at the albumin level in the patient's blood and also the calcium level we do a variety of other tests that are more for prognostic purposes including a beta 2 microglobulin and a lactate dehydrogenase test so suffice to say there's a battery of tests that are done for screening and then for more specific diagnoses we look for the cancer protein we employ a variety of methods to do so one is the serum protein electrophoresis another is quantitative immunoglobulins and then the serum free light chain assay as regards the tests in the urine we're at least initially trying to see if there is protein spilling into the urine and what kind of protein it is so we ask for actually a 24-hour urine collection to be done on patients as regards bone marrow biopsy we are doing a variety of tests in the bone marrow one is to look at the number of the plasma cells which are the cell type that gives rise to this cancer in the bone marrow normally they should be less than 5% of the cells and we in this condition do see that patients have more than 5% often majority of the cells in the bone marrow may be plasma cells in addition to looking at cells under the microscope we send the test off for chromosomal analysis and fish testing which gives us prognostic information and also seems to somewhat informal decision on how to treat patients imaging tests have historically been plain x-rays of all bones in the body this is something that still remains part of our testing but increasingly we are doing tests including PET CT scans and MRI scans of least the spine and the pelvis in several patients depending on their presentation you can keep track of your myeloma markers and the genetics of your myeloma in the myeloma genetics and the myeloma lab sections of help tree health tree is a place where you can track your disease in a single location