NCCN Guidelines for Patients® | Multiple Myeloma

16 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 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 Tissue biopsy for solitary plasmacytoma CBC with differential and platelet count Plasma cell proliferation Examination of peripheral blood smear Whole-body or skeletal MRI ( m agnetic r esonance i maging) Blood chemistry tests: BUN ( b lood u rea n itrogen), creatinine, creatinine clearance, electrolytes, calcium, albumin Whole-body FDG ( f luoro d eoxy g lucose) PET/ CT ( p ositron e mission t omography/ c omputed t omography) scan Uric acid Serum viscosity LDH ( l actate d e h ydrogenase) HLA ( h uman l eukocyte a ntigen) typing Beta-2 microglobulin Echocardiogram Serum FLC ( f ree l ight c hain) assay Evaluation for light chain amyloidosis 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 on bone marrow Plasma cell FISH ( f luorescence i n s itu h ybridization)