18 NCCN Guidelines for Patients ® : Multiple Myeloma, 2018 2 Testing for myeloma Urine tests Serum free light chain assay This test measures the amount of free light chains in the blood. This test is helpful even when it isn’t possible to measure the amount of M-proteins with SPEP or in urine. SPEP SPEP is a test that measures the amount of M-proteins in the blood. High levels may be a sign of advanced myeloma. SIFE SIFE is a test that finds the type of M-proteins present in the blood. It finds the type of M-proteins by showing which form of heavy chains and light chains they have. Serum viscosity Serum viscosity is a blood test that measures the thickness of your blood. A large amount of M-proteins in your blood can cause blood to become very thick—a condition called hyperviscosity. This can lead to neurological symptoms, headaches, vision problems, bleeding, and damage to your kidneys and other organs. HLA typing HLAs are special proteins found on the surface of most cells in the body. The unique set of HLA proteins on a person’s cells is called the HLA type or tissue type. All cells in a single person have the same HLA type. This helps the body to tell its own cells apart from foreign cells. It also affects how the body responds to foreign substances. HLA typing is a blood test that finds a person’s HLA type. This test is used to find the right donor for an allogeneic stem cell transplant—a treatment that may be considered for some patients with myeloma. (See Part 3 on page 24 for details about this treatment). Your HLA type and the donor’s HLA type must be a near-perfect match for this treatment to work. Urine tests Besides blood, doctors also test urine to look for signs of disease. Urine tests can be used to diagnose myeloma, assess if your kidneys are working well, and check the results of cancer treatments. Urine tests are also used to assess the tumor burden—the extent or amount of myeloma in your body. The urine tests that are used for myeloma are described next. Total protein Total protein is a test that measures the total amount and type of protein in urine. For this test, urine is collected over a 24-hour period. This test can show the amount of light chains, also called Bence Jones protein, in the urine. Testing 24-hour urine for light chains helps to measure the tumor burden in patients with myeloma cells that mainly or only make light chains. UPEP UPEP is a test that measures the amount of M-proteins in the urine. For this test, urine is collected for 24 hours and then sent to a lab for testing. This test is used to assess the tumor burden. It is given along with other initial tests when myeloma is first found. It may also be repeated to check how well treatment is working. UIFE UIFE is a test that identifies the type of M-proteins present in urine. This test is used to assess the tumor burden. It is given along with other initial tests when myeloma is first found. It may also be repeated to check how well treatment is working.