Multiple myeloma other diagnostic studies

Multiple myeloma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Multiple Myeloma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Echocardiograph and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Multiple myeloma other diagnostic studies On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Multiple myeloma other diagnostic studies All Images X-rays Echo and Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Multiple myeloma other diagnostic studies
CDC on Multiple myeloma other diagnostic studies
Multiple myeloma other diagnostic studies in the news
Blogs on Multiple myeloma other diagnostic studies
Directions to Hospitals Treating Multiple myeloma
Risk calculators and risk factors for Multiple myeloma other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Bone Marrow Biopsy

A bone marrow biopsy is usually performed to estimate the percentage of bone marrow occupied by plasma cells. This percentage is used in the diagnostic criteria for myeloma.

Diagnostic Criteria

In 2003, the International Myeloma Working Group agreed on diagnostic criteria for symptomatic myeloma, asymptomatic myeloma and MGUS (monoclonal gammopathy of undetermined significance):

• Symptomatic myeloma:
  1. Clonal plasma cells >10% on bone marrow biopsy or (in any quantity) in a biopsy from other tissues (plasmacytoma)
  2. A monoclonal protein (paraprotein) in either serum or urine
  3. Evidence of end-organ damage (related organ or tissue impairment, ROTI):
     • Hypercalcemia (corrected calcium >2.75 mmol/L)
     • Renal insufficiency attributable to myeloma
     • Anemia (hemoglobin <10 g/dL)
     • Bone lesions (lytic lesions or osteoporosis with compression fractures)
     • Frequent severe infections (>2 a year)
     • Amyloidosis of other organs
     • Hyperviscosity syndrome
• Asymptomatic myeloma:
  1. Serum paraprotein >30 g/L AND/OR
  2. Clonal plasma cells >10% on bone marrow biopsy AND
  3. NO myeloma-related organ or tissue impairment
• Monoclonal gammopathy of undetermined significance (MGUS):
  1. Serum paraprotein <30 g/L AND/OR
  2. Clonal plasma cells <10% on bone marrow biopsy AND
  3. NO myeloma-related organ or tissue impairment

Related conditions include solitary plasmacytoma (a single tumor of plasma cells, typically treated with irradiation), plasma cell dyscrasia (where only the antibodies produce symptoms, e.g. AL amyloidosis), and POEMS syndrome (peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes).