Testing for Multiple Myeloma

Doctors order a range of tests to diagnose and stage myeloma accurately. They also use testing to determine the type of myeloma a patient has and to monitor how the patient responds to treatment. Find out more about the various tests and how health professionals use multiple myeloma lab results to support your treatment.

What Can Tests Tell Us?

Testing is the most important tool that your doctor uses to:

• Diagnose monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and active myeloma.
• Assess the stage of your myeloma.
• Assess your genetic risk factors.
• Assess the risk of disease progression.
• Assess your response to treatment.
• Monitor you during periods of remission.
• Determine if treatment needs to be started.
• Monitor for disease-related and treatment-related side effects. 

How Do You Test for Multiple Myeloma?

Doctors order a range of tests to determine a patient's condition. Each test can be thought of as a piece of the puzzle. Only when the pieces are assembled together can patients and their doctors make proper conclusions and decisions.

Because myeloma is unique to each patient, it’s important not to compare your test results with those of other patients. We encourage you to discuss all your test results with your doctor. Your doctor can put all the puzzle pieces together to contextualize your results. Over time, doctors can see an emerging pattern from your test results, and this is more meaningful than any single test itself.

It is always best to discuss your test results with the doctor treating your myeloma. The key points to discuss with your doctor are:

• Is your lab test result outside the normal range or not? 
• Does your test result show a change from prior testing?
• If your test shows an unexpected change, ask your doctor to repeat the test. 

What Tests Are Done for Multiple Myeloma​?

Patients undergo various diagnostic tests for multiple myeloma, as well as tests to stage the disease and determine the type of myeloma. Test fall into three major categories, including:

Blood Tests

While doctors use blood tests for diagnosis, they also use them throughout the course of the disease. The most common blood test to diagnose and monitor myeloma is a Complete Blood Count (CBC). Your blood cells are made in your bone marrow, but with too many myeloma cells present, your bone marrow cannot produce the same amount of blood cells. By determining your levels of white and red blood cells as well as your blood-clotting cells (platelets), this test can help identify the disease and assess your response to treatment.

Urine Tests

A urine protein electrophoresis (UPEP) test can determine if monoclonal immunoglobulin has filtered through the kidney. Patients need to give a urine sample over a 24-hour period to detect how much monoclonal immunoglobulin is present. Another test, called urine immunofixation, can determine the type of abnormal antibodies in the urine.

Bone Marrow Tests

Doctors will order a bone marrow aspiration (an extraction of liquid bone marrow) and a bone marrow biopsy (an extraction of bone marrow tissue) to diagnose the disease and monitor treatment effects. These tests provide direct access to myeloma cells. However, they don't always accurately represent a patient's condition, as myeloma cells are not evenly distributed.

Imaging Studies 

Because 70%–80% of patients already have a bone disease when they receive a myeloma diagnosis, doctors will determine how the disease impacts your skeletal system through imaging tests. These may include:

• X-rays
• Magnetic resonance imaging (MRI) scans
• Positron emission tomography (PET) scans
  Computed tomography (CT) scans

Save Copies of Your Test and Lab Results

It is important to request, print out, and save copies of your results. Bring a summary of results with you to all oncology visits or when getting a second opinion.

Variables That May Affect Your Test Results 

Be aware that your lab results can be affected by many variables, including:

• Other medications and supplements that you may be taking
• The amount and type of fluids you have consumed
• Whether you have eaten before the test

Before undergoing tests, consult with your doctor to make sure there are no special instructions about taking certain medications, supplements, food, or drinks.

Get the Information and Support You Need

The International Myeloma Foundation offers comprehensive information about multiple myeloma on its website. Our extensive resource library offers free, downloadable resources, and we also offer one-on-one support through InfoLine. Schedule an InfoLine call, and one of our caring and compassionate coordinators will be in contact.