This article first appeared on the Multiple Myeloma Research Foundation website and is reprinted here with their permission.
Diagnostic testing for multiple myeloma is important, because many myeloma patients don’t have any multiple myeloma symptoms until their disease has reached more advanced stages. With that in mind, there are three primary forms of myeloma testing that doctors can conduct to identify myeloma cells in patients: blood tests, urine tests, or bone marrow tests.
Multiple Myeloma Blood Tests
Multiple myeloma blood tests involve the laboratory analysis of blood, which may reveal the M proteins produced by myeloma cells. Myeloma blood testing also looks for an abnormal protein produced by myeloma cells called beta-2-microglobulin. If these proteins are detected in blood, it gives doctors clues about the myeloma’s aggressiveness. Myeloma blood tests also examine your kidney function, blood cell counts, calcium levels and uric acid levels. Multiple myeloma testing is incredibly important for not only diagnosing the disease, but also for planning and monitoring treatment.
How is multiple myeloma detected via blood tests?
Multiple myeloma is a difficult disease to diagnose early. Many patients don’t show any symptoms until their disease has reached a more advanced stage. Myeloma symptoms can also appear to be caused by something else, such as a cold. Sometimes, the disease may be found in people without symptoms when a routine blood test shows elevated levels of M protein in the blood. Multiple myeloma without symptoms is called smoldering myeloma.
- Complete blood count (CBC): CBCs measure the levels of certain cells within the blood, including red cells, white cells, or platelets. If myeloma cells take up too much of the bone marrow, certain cell levels will be low. Low red blood count is the most common finding of a CBC.
- Quantitative immunoglobulins: analyzes blood levels of immunoglobulins. Levels of immunoglobulins are measured to see if any are too high or too low. In multiple myeloma, the level of one type may be high while the others are low.
- SPEP (serum protein electrophoresis): This test looks at the different proteins in the blood to see if the blood contains an abnormal myeloma protein. It is one of the first tests your doctor will order if myeloma is suspected.
- Free light chain assay: Because the myeloma protein isn’t always a whole antibody, doctors conduct the Free Light Chain Assay to measure a small part of the antibody known as the light chain.
- Beta-2 microglobulin: High levels of Beta-2 microglobulin are shown in patients with multiple myeloma. The test is used to predict outlook or to monitor treatment results.
- Blood chemistry tests: These tests analyze kidney function and different chemical and electrolyte levels in the blood.
Myeloma urine tests assist doctors in the diagnosis of multiple myeloma. Multiple myeloma urine tests are conducted to detect M proteins, which are abnormal antibody fragments. These M proteins are excessively produced by an abnormal clonal proliferation of plasma cells. Pathologists will check urine for these abnormal antibodies made by the cancerous plasma cells in multiple myeloma. Common names for these abnormal antibodies include: monoclonal immunoglobulins, paraproteins, or M proteins.
- **Bence-Jones Protein Test **
The Bence-Jones Protein Test is the primary urine test that pathologists conduct to diagnose myeloma. The test measures the levels of Bence-Jones proteins in urine. Bence-Jones proteins are not present in the urine of healthy patients, and 75% of multiple myeloma patients will have Bence-Jones protein detected in their urine.
Bone Marrow Tests
A multiple myeloma bone marrow test is conducted to detect myeloma cells in a patient’s bones or bone marrow. Myeloma bone marrow testing helps doctors diagnose multiple myeloma by evaluating bone health. The primary effect of multiple myeloma is on the bone, so bone damage is a common symptoms of multiple myeloma.There are 5 common bone marrow tests that doctors conduct to diagnose multiple myeloma:
A bone marrow biopsy tests the number of plasma cells in the bone marrow. The procedure requires a sample of solid bone tissue that is typically taken from the hip.
- Cytogenic Analysis (FISH)
Cytogenetic analysis is a technique that lets doctors analyze chromosomes
in a patient’s bone marrow cells. If doctors detect chromosome abnormalities, it may indicate multiple myeloma. Cytogenetic testing can take up to 3 weeks, as the cells must grow for a couple weeks before doctors can evaluate the chromosomes under a microscope.
Flow cytometry is a common myeloma test that can discover abnormal strands of DNA in bone marrow. Flow cytometry involves putting myeloma cells under a laser beam so that their DNA can be analyzed.
MRI scans help look at bones when diagnosing myeloma. MRI scans uses radio waves and magnets to produce images of a patient’s bones. It is a particularly helpful procedure when doctors need to evaluate the bones of the spine.
Skeletal surveys are a series of x-rays of the skull, spine, arms, ribs, pelvis, and legs. These tests help doctors identify bone damage or bone deterioration, a common symptom of myeloma. For more information on myeloma bone marrow tests, consult with a physician. Additional information on other myeloma tests, include blood tests or urine tests, is available in the Multiple Myeloma Knowledge Center.Please take a moment and consider donating to the Multiple Myeloma Research Foundation (MMRF). Follow this link and donate what you can.