NCCN Guidelines for Patients™: Multiple Myeloma
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See pages 13 – 19
for more information
on cancer tests.
5.1 Multiple myeloma testing
detect multiple myeloma correctly when it is present. The assay is also useful
for cancer prognosis and follow-up of amyloidosis and oligosecretory myeloma.
A bone marrow aspiration and biopsy is recommended to confirm if you have
myeloma. Bone marrow immunohistochemistry assesses if M-proteins are
present, and multiparameter flow cytometry counts the number of myeloma
cells. Genetic testing of bone marrow can find changes in genes linked
to myeloma. Genetic testing may show if genes from two cells have been
switched, if genes are missing, or if too many copies of a gene have been
Your doctor may also want you to have tests from the second list in the chart.
MRI, CT, or PET/CT may be useful to view body areas where symptoms are
present. Images may show cancer or if you have bone damage. If a solitary
plasmacytoma is seen, it needs to be confirmed with a tissue biopsy. Bone
densitometry testing can be used to assess bone strength to see if you need
drugs that prevent or treat bone damage.
There are two other bone marrow and blood tests that might be useful. Staining
of bone marrow (and your fat pad) is done to check for amyloid, and plasma
cell labeling index assesses how fast myeloma cells are dividing. Blood
thickness is assessed with a serum viscosity test. HLA typing is needed if you
will have an allogeneic stem cell transplant.
If the myeloma is a solitary plasmacytoma, see Part 5.2 for treatment
recommendations. For multiple myeloma, go back to the
on page 41
to find out which pages to read next.
Allogeneic stem cell
stem cells from a donor
of amyloid in tissue
tissue in the center of bone
Instructions in cells
for making new cells
antibody made by myeloma
cells that doesn’t fight germs
Myeloma that has few or no
The course and
outcome of a disease
One mass of myeloma cells