Multiple myeloma laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Laboratory findings consistent with the diagnosis of multiple myeloma include abnormal complete blood count, erythrocyte sedimentation rate (ESR), basic metabolic panel, electrophoresis and immunohistochemistry. An elevated concentration of serum protein level without concomitant elevation of serum albumin level is very suggestive of multiple myeloma.[1][2]

Laboratory Findings

Complete blood count[3][4]

Peripheral blood smear

Basic metabolic panel[7][8]

Urinalysis[9][10]

  • A 24-hour collection of urine is usually needed to examine the amount of protein

Electrophoresis[11][12]

  • Protein electrophoresis is a method that separates proteins in the serum or urine
  • 70% of cases have high levels of IgG
  • 20% of cases have high levels of IgA
  • 5–10% of cases have only immunoglobulin light chains (Bence Jones proteins)
  • Rarely κ- or λ-light chains may be secreted in isolation

Free light chain immunoassay

  • Potentially offers an improvement in monitoring disease progression and response to treatment[13][14]

Immunofixation

  • Identifies the type of M-protein or immunoglobulin light chain detected by serum or urine electrophoresis[15][16]

Quantitative immunoglobulins assay[17][18]

  • Quantitative measurement of IgA, IgG, IgM immunoglobulins to detect immune paresis
  • Monoclonal gammopathy (IgA and/or IgG peak)
  • Reverse albumin:globulin ratio (low albumin, high globulin)
  • Elevated β2-microglobulin level

Immunohistochemistry

References

  1. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  2. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  3. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  4. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  5. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  6. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  7. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  8. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  9. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  10. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  11. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  12. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  13. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  14. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  15. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  16. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  17. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  18. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  19. Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  20. Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015


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