Symptoms and Tests | Testing

Blood Cell Counts: A complete blood count (CBC) is a test that measures the levels of red cells, white cells, and platelets in your blood. Most people with multiple myeloma have a low red blood cell count, which is called anemia.
Blood Chemistry Tests: Tests might be done to check how well your kidneys are functioning and how much creatinine, albumin, calcium, potassium, sodium, lactic dehydrogenase (LDH) and other chemicals are in your blood. In multiple myeloma, LDH levels can be used to help determine chance of recovery (prognosis) and stage.
Serum Albumin and Serum Beta-2 Microglobulin (β2-M): Serum albumin is a blood protein made by the liver that's necessary for maintaining general health and appropriate blood volume. β2-M is a protein that plays a role in your body's immune response. These can both be measured through blood tests.
Serum Free Light Chain Assay: A test that measures the amount of free light chains in the blood. The more free light chains present, the more aggressive the disease is.
Quantitative Immunoglobulins: This test measures the amount of each type of antibody (immunoglobulins) in the blood. These antibodies include immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM). Abnormal levels of an antibody can indicate it's growing out of control.
Electrophoresis: Myeloma cells produce a monoclonal antibody known as M-protein. Finding a monoclonal antibody in the blood may be the first step in diagnosing multiple myeloma. M-protein levels in a person's blood and urine are used to determine the extent of the cancer, monitor how well treatment is working, and whether the cancer is progressing or coming back. Serum protein electrophoresis (SPEP) is a test that measures the amount of M-proteins in the blood and is used for diagnosis and monitoring. Serum immunofixation electrophoresis (SIFE) tests which type of M-proteins are in the blood.
Urine tests: A urine sample is tested to look for myeloma protein that's filtered through your kidneys. These tests are known as urine protein electrophoresis (UPEP).

Bone Marrow Aspiration and Biopsy: People with multiple myeloma have too many plasma cells in their bone marrow, which has both a solid and liquid part. These procedures examine the bone marrow tissue further using a needle and are often done at the same time through the pelvic bone (located in the lower back by the hip). An aspiration removes a sample of the fluid and a biopsy removes a small amount of tissue. Additional tests can also help determine the genetic makeup of the multiple myeloma.
Fine Needle Aspiration (FNA): A thin needle and syringe are used to extract a small amount of tissue from a tumor or lymph node (instead of surgery) and can be further guided through a CT scan.
Core Needle Biopsy: Although this test is similar to an FNA, a larger needle is used to remove a larger tissue sample.

Lab tests on a tumor and/or bone marrow sample may be recommended to identify specific chromosomes, genes and proteins, in addition to other factors unique to the tumor. These results can help determine the most appropriate treatment option for you.

Cytogenetics is the study of genetic changes in cells, and molecular testing may be conducted on a tissue sample to understand how aggressive the cancer is.
Fluorescence in situ hybridization (FISH) is a type of cytogenetic test that uses a fluorescent dye to see changes in a person's chromosomes and helps the doctor predict prognosis and whether the multiple myeloma is high risk and aggressive.
Minimal residual disease (MRD) tests.

X-ray: An x-ray is usually the first step in evaluating bones when multiple myeloma is suspected, where a patient's skeletal system is evaluated (also known as bone or skeletal survey).
CT or CAT Scan (Computed Tomography Scan): This scan uses detailed 3-D computer-generated images of the inside of your body to show any abnormalities or tumors in the soft tissues. Although an intravenous contrast dye is often used in CT scans for other types of cancer, it is usually avoided in people with multiple myeloma. Be sure to discuss with your radiologist or technician.
MRI (Magnetic Resonance Imaging): An imaging test that uses magnetic fields to show detailed images of soft tissues in the body and is helpful in looking at bones, brain, pelvis and spinal cord. An MRI can also be used to measure size of tumor and/or show a tumor pressing on nerve roots.
PET Scan (Positron Emission Tomography): A test that uses a radioactive sugar substance (injected into body) and special camera to take pictures inside of body that show areas where sugar is collected through the body (since cancer cells absorb high amount of this sugar). Usually combined with a CAT scan.
ECHO (Echocardiogram): An ultrasound that uses sound waves to assess how well the heart is workings.

Testing

What types of tests will I receive?

Blood and Urine Tests

Biopsies

Biomarker/Molecular Testing

Imaging Tests