Diagnosis and Prognosis of Multiple Myeloma
- Magnetic resonance imaging (MRI)
- Computed tomography scan (CT scan)
- Positron emission tomography/computed tomography scan (PET/CT scan)
- Urine tests
- Blood tests
- Bone marrow aspiration or biopsy
- Blood or urine level of abnormal antibody-like proteins—These are produced by myeloma cells.
- Blood level of calcium—High levels are linked to bone damage caused by myeloma cells growing in the bone marrow and destroying the surrounding bone as their mass expands.
- Bone damage evident on x-ray—This is also a result of destruction of bone caused by growing myeloma cells. This damage has a characteristic appearance on x-ray. Sometimes an x-ray alone will give good evidence of myeloma.
- Blood hemoglobin level—Hemoglobin is the red pigment in red blood cells that carries oxygen to the cells. Low levels may point to decreased production of red cells due to myeloma cells occupying the bone marrow.
- Blood level of beta-2-microglobulin—This is another protein produced by myeloma cells. Increased levels of this protein suggest a large amount of myeloma in the body.
- A somewhat small number of myeloma cells are present. (This can be measured by plasma cell index.)
- Hemoglobin levels are slightly low.
- Bone x-rays show no damage or only one area of damage.
- Calcium levels are normal, indicating that there is not much bone damage.
- There is a small amount of abnormal antibody-like protein in the blood or urine.
- A moderate amount of myeloma cells are present.
- Other factors fall in a range between Stage I and Stage III.
- A large amount of myeloma cells are present.
- Hemoglobin levels are very low, indicating that the normal bone marrow cells are being crowded out.
- Calcium levels are high, indicating that there is a large amount of bone destruction.
- X-rays show more than three areas of bone destruction.
- A large amount of abnormal antibody-like protein is in the blood or urine.
Cancer Medicine e5 . 5th ed. Hamilton, Ontario: BC Decker Inc; 2000.
Casciato D., Territo M. Manual of Clinical Oncology . sixth edition, 2009, Lippincott Williams & Wilkins.
Greipp PR, San Miguel J, et al. International staging system for multiple myeloma. J Clin Oncol . 2005;23(15):3412-3420.
Rakel R. Bope E, ed. Conn's Current Therapy 2002 . 54th ed. St. Louis, MO: WB Saunders Company; 2002: 439-443.
Treating multiple myeloma: bisphosphonates for multiple myeloma. Available at: http://www.cancer.org/Cancer/MultipleMyeloma/DetailedGuide/multiple-myeloma-treating-bisphosphonates . Updated July 24, 2012. Accessed December 27, 2012.
Treating multiple myeloma: chemotherapy and other drugs for multiple myeloma. Available at: http://www.cancer.org/Cancer/MultipleMyeloma/DetailedGuide/multiple-myeloma-treating-chemotherapy . Updated July 24, 2012. Accessed December 27, 2012.
Treating multiple myeloma: plasmapheresis for multiple myeloma. Available at: http://www.cancer.org/Cancer/MultipleMyeloma/DetailedGuide/multiple-myeloma-treating-plasmapheresis . Updated July 24, 2012. Accessed December 27, 2012.
Treating multiple myeloma: radiation therapy for multiple myeloma. Available at: http://www.cancer.org/Cancer/MultipleMyeloma/DetailedGuide/multiple-myeloma-treating-radiation . Updated July 24, 2012. Accessed December 27, 2012.
Treating multiple myeloma: stem cell transplant. Available at: http://www.cancer.org/Cancer/MultipleMyeloma/DetailedGuide/multiple-myeloma-treating-stem-cell-transplant . Updated July 24, 2012. Accessed December 27, 2012.
Multiple myeloma. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated September 13, 2012. Accessed December 27, 2012.
- Reviewer: Mohei Abouzied, MD
- Review Date: 09/2013
- Update Date: 09/30/2013