In some cases, your doctor may detect multiple myeloma accidentally when you undergo a blood test for some other condition. In other cases, your doctor may suspect multiple myeloma based on your signs and symptoms.
Tests and procedures used to diagnose multiple myeloma include:
Blood tests. Laboratory analysis of your blood may reveal the M proteins produced by myeloma cells. Another abnormal protein produced by myeloma cells — called beta-2-microglobulin — may be detected in your blood and give your doctor clues about the aggressiveness of your myeloma.
Additionally, blood tests to examine your kidney function, blood cell counts, calcium levels and uric acid levels can give your doctor clues about your diagnosis.
- Urine tests. Analysis of your urine may show M proteins, which are referred to as Bence Jones proteins when they're detected in urine.
Examination of your bone marrow. Your doctor may remove a sample of bone marrow for laboratory testing. The sample is collected with a long needle inserted into a bone (bone marrow aspiration and biopsy).
In the lab, the sample is examined for myeloma cells. Specialized tests, such as fluorescence in situ hybridization (FISH) can analyze myeloma cells to understand their chromosome abnormalities. Tests are also done to measure the rate at which the myeloma cells are dividing.
- Imaging tests. Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include an X-ray, MRI, CT or positron emission tomography (PET).
Assigning a stage and a risk category
If tests indicate you have multiple myeloma, your doctor will use the information gathered from the diagnostic tests to classify your disease as stage 1, stage 2 or stage 3. Stage 1 indicates a less-aggressive disease, and stage 3 indicates an aggressive disease that may affect bone, kidneys and other organs.
Your multiple myeloma may also be assigned a risk category, which indicates the aggressiveness of your disease.
Your multiple myeloma stage and risk category help your doctor understand your prognosis and your treatment options.
July 29, 2017
- Kaushansky K, et al., eds. Myeloma. In: Williams Hematology. 9th ed. New York, N.Y.: McGraw-Hill Education; 2016. http://www.accessmedicine.com. Accessed March 31, 2017.
- Ferri FF. Multiple myeloma. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed March 31, 2017.
- Niederhuber JE, et al., eds. Multiple myeloma and related disorders. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed April 23, 2017.
- Multiple myeloma. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 31, 2017.
- Plasma cell neoplasms (including multiple myeloma) treatment (PDQ). National Cancer Institute. https://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq. Accessed April 23, 2017.
- Goldman L, et al., eds. Plasma cell disorders. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed April 30, 2017.
- Kyprolis (prescribing information). South San Francisco, Calif.: Onyx Pharmaceuticals, Inc.; 2012. http://www.kyprolis-hcp.com/. Accessed April 23, 2017.
- Velcade (prescribing information). Cambridge, Mass.: Millennium Pharmaceuticals, Inc.; 2012. http://www.velcade.com. Accessed April 23, 2017.
- Integrative medicine and complementary and alternative therapies. The Leukemia & Lymphoma Society. https://www.lls.org/treatment/integrative-medicine-and-complementary-and-alternative-therapies. Accessed April 23, 2017.
- Warner KJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. April 11, 2017.
- Russell SJ, et al. Remission of disseminated cancer after system oncolytic virotherapy. Mayo Clinic Proceedings. 2014;89:926.
- Ninlaro (prescribing information). Cambridge, Mass.: Millennium Pharmaceuticals, Inc.; 2016. https://www.ninlarohcp.com. Accessed April 30, 2017.
- AskMayoExpert. Multiple myeloma. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.