NCCN Guidelines for Patients® | Multiple Myeloma

16 NCCN Guidelines for Patients ® : Multiple Myeloma, 2018 2 Testing for myeloma Blood tests Guide 1. Tests for multiple myeloma Initial tests needed for most patients Tests that may be useful for some patients • Medical history and physical exam • Whole-body or skeletal MRI ( m agnetic r esonance i maging) • CBC with differential and platelet count • Whole-body PET/CT ( p ositron e mission t omography/ c omputed t omography) scan • Exam of peripheral blood smear • Tissue biopsy for solitary plasmacytoma • Blood chemistry tests: • Plasma cell proliferation ◦◦ BUN ( b lood u rea n itrogen), creatinine (creatinine clearance), electrolytes, calcium, albumin • Serum viscosity ◦◦ Uric acid • HLA ( h uman l eukocyte a ntigen) typing ◦◦ LDH ( l actate d e h ydrogenase) • Echocardiogram ◦◦ Beta-2 microglobulin • Evaluate for light chain amyloidosis, if appropriate • Serum FLC ( f ree l ight c hain) assay • Serum quantitative immunoglobulins • SPEP ( s erum p rotein e lectro p horesis) • SIFE ( s erum i mmuno f ixation e lectrophoresis) • 24-hour urine for total protein • UPEP ( u rine p rotein e lectro p horesis) • UIFE ( u rine i mmuno f ixation e lectrophoresis) • Bone survey or whole-body low-dose CT ( c omputed t omography) scan • Bone marrow biopsy and aspiration • Bone marrow immunohistochemistry and/or bone marrow flow cytometry • Cytogenetics testing • Plasma cell FISH ( f luorescence i n s itu h ybridization)