NCCN Guidelines for Patients
Multiple Myeloma, Version 1.2014
Tests for myeloma
Doctors test blood to look for signs of disease.
Blood is made of white blood cells, red blood cells,
and platelets, but it also has many proteins and
other chemicals. Blood tests can be used to confirm
(diagnose) myeloma, assess if organs are working
well, and check the results of cancer treatments.
Blood tests can also be used to assess the amount
of cancer in the body, called the tumor burden. The
blood tests used for myeloma are described next.
• SPEP (
measures the amount of M-proteins in the
blood. High levels may be a sign of advanced
• SIFE (
identifies the type of M-proteins by showing
which form of heavy chains and light chains
• Serum quantitative immunoglobulins
measures the amount of each type of antibody
in the blood to see if any are abnormally high
• Serum free light chain assay measures the
number of free light chains in the blood. This
test is helpful when it isn’t possible to measure
the amount of M-proteins found with SPEP or
• Beta-2 microglobulin is a small protein made
by various cells, including myeloma cells. It is
measured with a blood chemistry test. High
levels may be a sign of advanced myeloma.
• LDH (
ydrogenase) is a protein
made by myeloma cells. It is measured with
a blood chemistry test. High levels may be a
sign of advanced myeloma.
• Albumin is the main protein in blood plasma
and is measured with a blood chemistry test.
Low levels of this protein may be a sign of
• A CBC (
ount) measures the
number of white blood cells, red blood cells,
and platelets. As myeloma cells take over the
bone marrow, too few normal blood cells are
• HLAs (
ntigens) are special
proteins on the surface of white blood cells.
These proteins help the body to identify its
own cells from foreign cells. An HLA type is
a unique set of proteins on a person’s white
blood cells. HLA types differ among people
just like blood types differ among people.
HLA typing is a test that finds a person’s HLA
type. HLA typing is done before treatment
that transfers blood stem cells from another
person to the patient (see page 27). It is very
important that their HLA types are a near-
perfect match for this treatment to work. This
is because the HLA type affects how the body
responds to foreign substances.
• Calcium is a mineral found in bones. High
levels of calcium in the blood may be a sign of
myeloma destroying bone.
• Creatinine is waste from muscles that is
filtered out of blood into urine by the kidneys.
It is measured with a blood chemistry test.
High levels of creatinine in the blood may be a
sign of kidney damage.