NCCN Guidelines for Patients® | Multiple Myeloma

17 NCCN Guidelines for Patients ® : Multiple Myeloma, 2018 2 Testing for myeloma Blood tests If you have abnormal CBC test results, a pathologist may also look at the blood sample on a glass slide under a microscope (peripheral blood smear). A pathologist is an expert in examining cells for disease. He or she can see the blood cells in more detail for a diagnosis of multiple myeloma. They may be able to observe myeloma cells in the blood. Blood chemistry tests Blood chemistry tests measure the levels of different chemicals in your blood. Chemicals in your blood come from your liver, bone, and other organs and tissues. Abnormal levels of certain chemicals in the blood may be a sign that an organ isn’t working well. These abnormal levels can also be caused by cancer or other health problems. The main substances your doctors will assess for with chemistry tests are described next. BUN BUN is a waste product made by the liver and filtered out of blood into urine by the kidneys. BUN is measured with a blood chemistry test and high levels may be a sign of kidney damage. Creatinine 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. It is recommended that your doctor calculate or measure the creatinine clearance. A creatinine clearance involves taking a 24-hour sample of urine and comparing it to the level of creatinine in your blood. This test is needed to see how well your kidneys are working. Electrolytes Electrolytes are minerals in the blood that are needed for organs to work well. They are measured with a blood chemistry test. High levels of electrolytes such as sodium, potassium, and calcium may be a sign of kidney damage. Calcium Calcium is a mineral that is found in many body tissues, but mostly in the bones. It is measured with a blood chemistry test. High levels of calcium in the blood may be a sign of myeloma destroying bone. Too much calcium in your blood can damage your kidneys. Albumin 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 advanced myeloma. LDH LDH is a protein made by many types of cells, including myeloma cells. It is measured with a blood chemistry test. High levels of LDH may be a sign of advanced myeloma. Beta-2 microglobulin Beta-2 microglobulin is a small protein made by many types of cells, including myeloma cells. It is measured with a blood chemistry test. High levels of this protein may be a sign of advanced myeloma. Uric acid Uric acid is one of the chemicals released by dying cancer cells. Very high levels of uric acid and other chemicals in the blood can be very dangerous. It can cause serious damage to organs such as the kidneys. Serum quantitative immunoglobulins This test measures the amount of each type of antibody in the blood. It will show if the level of any type of antibody is abnormal—too high or too low. These are the kinds of antibodies (immunoglobulins) that were mentioned on page 9, called A, G, M, D, and E. Typically, the G, A, and M types of immunoglobulins are tested, as myeloma with other types are uncommon.

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