Related tests and laboratory values. The objective of the tests used in the case of multiple myeloma is the establish the diagnosis, to determine their severity and spread, monitor its progress, complications and monitor the efficacy of treatment. There is no single evidence allowing to diagnose multiple myeloma.
In the majority of cases diagnosed through a combination of signs and symptoms, a good story clinic, a complete physical exam, plus required laboratory tests or Imaging tests.
Laboratory tests
It is possible that multiple myeloma is diagnosed in a routine examination that shows a concentration of protein and calcium in higher than normal blood and decrease in the number of red blood cells and white blood cells and/or a moderate or major amount of proteins in urine. These data can be seen also in other diseases, so it should be other tests to confirm the diagnosis.
The tests used as an aid to the diagnosis of multiple myeloma one or more of the following include:
- Electrophoresis of proteins and immunofixation – are used for the diagnosis and monitoring of multiple myeloma
- Bence Jones protein (free light chains) – can be detected in urine in some people with multiple myeloma.
- Light chains free of immunoglobulins in serum – this test measures the amount of blood immunoglobulin free light chains.
- Immunoglobulin – different types of immunoglobulins (usually IgG, IgA and IgM) are measured.
- Aspirate and biopsy of bone marrow – multiple myeloma is a disease of the bone marrow.
- Pairs heavy/light chain immunoglobulin measurement – this is a test of recent introduction that allows you to differentiate between different types of each type of immunoglobulin light chains (for example, can distinguish a type IgG a lambda type IgG kappa).
Other laboratory tests
Other tests used for the diagnosis, monitoring and detection of complications are:
- Metabolic panel full to assess kidney and other organ function, fluid and electrolyte balance and the concentration of calcium and total protein.
- Blood count to know the number of red blood cells, platelets, and leukocytes and the severity of the anemia (hemoglobin amount).
- Uric acid can be elevated in some mieloma.
- Beta-2 microglobulin, a protein that is found in the membrane surface of different cells, including those of myeloma; its growth means worse prognosis, although you can also be elevated in other diseases.
Other diagnostic tests (non-laboratory)
- Radiology, useful in the diagnosis, staging, and monitoring; detects bone lesions and the number and size of possible bone tumors.
- MRI (magnetic resonance imaging) may be more useful than the radiology when assessing the bone destruction.
- CT (computed tomography) to assess tumors bone.
| Test | Name | NORMAL VAL | PC * | notes |
| full blood count | Level white blood cells | 4.0-11.0 | x 10 ^ 9/l | a low level makes you more vulnerable to infections |
| Level of red blood cells (men) | 4.5 – 6.5 | x 10 ^ 12/l | a low level is anemia, which cause fatigue | |
| Level of red blood cells (women) | 3.9 – 5.6 | x 10 ^ 12/l | a low level is anemia, which cause fatigue | |
| Hemoglobin (men) | 13.5 – 18.0 | g/dl | a low level of hemoglobin is also anemia, which cause fatigue | |
| Hemoglobin (women) | 11.5 – 16.0 | g/dl | a low level of hemoglobin is also anemia, which cause fatigue | |
| Platelets | 150-400 | x 10 ^ 9Y/l | a low level makes your blood or bruising easily occur | |
| urea, creatinine and electrolytes | Urea | 2.5-6.7 | mmol/l | measurement of renal function |
| Creatinine | 70-150 | µmol/l | measurement of renal function | |
| Calcio (total) | 2.12 – 2.65 | mmol/l | raised by produced by myeloma bone disease | |
| proteins | Albumin | 35-50 | g/l | sometimes is reduced in cases of myeloma by the presence of paraprotein |
| Total protein | 60-80 | g/l | sometimes increases in cases of myeloma by the presence of paraprotein | |
| Paraprotein | 0 | g/l | abnormal protein found in several diseases, including myeloma |
Explanation of units
g/dl the amount of grams that are in a deciliter (one-tenth of a litre) of blood.
g/l the amount of grams that are in a liter of blood
x 10 ^ 9/l how many billions of cells there is in a liter of blood
x 10 ^ 12/l how many billions of cells there is in a liter of blood
mmol/l how many thousandths part of a mole there is in a liter of blood
µmol/l how many parts millionth of a mole there is in a liter of blood
MOL unit of measurement standard used in chemistry to determine the quantity of a substance
It should take into account physicians do not use a liter of blood to perform these steps, simply take a sample of a few milliliters and then multiplying the results.