NCCN Guidelines for Patients® | Multiple Myeloma - page 42

NCCN Guidelines for Patients™: Multiple Myeloma
Version 1.2012
5.1 Multiple myeloma testing
Part 5.1 describes the recommended tests for when your
doctor thinks you may have multiple myeloma. These
tests are used to diagnose myeloma and to assess if
the cancer is causing symptoms. The first list of tests is
recommended for everyone. Tests from the second list
may be useful for some people.
With your medical history and a physical exam, your
doctor can assess if you’re having myeloma symptoms,
such as fatigue or bruising. Some blood tests are also
used to assess for symptoms of myeloma. A CBC will
show if the number of blood cells is low for each blood
cell type. A chemistry/metabolic panel measures BUN,
electrolytes, and creatinine levels to test if your kidneys
are working properly. The panel also measures calcium
to test for bone damage and measures LDH, albumin,
and beta-2 microglobulin to test for myeloma severity.
Bone damage may be seen with a bone survey.
The other blood tests as well as the urine tests in the first
list are used to test for M-proteins. Very often, the serum
free light chain assay along with SPEP and SIFE can
• Medical history and physical exam
• Blood tests:
▪▪ CBC
▪▪ Chemistry/metabolic panel
▪▪ Serum free light chain assay
▪▪ Serum quantitative immunoglobulins, SPEP, and SIFE
• Urine tests:
▪▪ Total protein
• Bone survey
• Bone marrow aspiration and biopsy
• Imaging tests:
▪▪ MRI
▪▪ CT scan without contrast
▪▪ PET/CT scan
▪▪ Bone densitometry
• Tissue tests:
▪▪ Tissue biopsy for solitary plasmacytoma
▪▪ Staining of marrow and fat pad
▪▪ Plasma cell labeling index
• Blood tests:
▪▪ Serum viscosity
▪▪ HLA typing
Tests for multiple myeloma
First tests
Possible other tests
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