There is not a single test or medical procedure that can accurately diagnose a patient for multiple myeloma. Instead, multiple factors are considered before a diagnosis is made. Please review the sections below for more information on these specific factors.

Blood Test

Blood tests show the components of the blood. When a person has myeloma, specific blood cells and proteins, which are identified through a test called protein electrophoresis, are present in excess amounts in the blood. For example, a myeloma patient’s blood test might show high levels of plasma cells, calcium (manifesting itself as hypercalcemia), monoclonal (M) protein, and/or beta-2-microglobulin.

Urine Test

Patients’ urine is tested to check for a specific type of M protein called the Bence Jones protein. Typically, doctors measure the amount of Bence Jones protein found in the urine over a 24-hour period. If a large amount is measured in a patient, his or her kidneys may be monitored because Bence Jones proteins can clog and damage them.

X-rays, MRIs, and PET Scans

X-rays can be used to check for broken or thinning bones, both of which are symptoms of myeloma. The ribs, back, pelvis, skull, hands, arms, legs, and feet may be examined. Magnetic Resonance Imaging (MRI) can also be used to examine bones, as well as bone marrow. The MRI is a computerized scan that can show the amount of myeloma cells present in the body. Positron Emission Topography, or PET scanning, is another imaging technique that displays myeloma cell activity and is useful to determine whether clusters of myeloma cells are benign or malignant.

Biopsy

A biopsy involves removing tissue from the body to examine it for diagnostic purposes. In order to diagnose myeloma patients, bone marrow is removed from the hipbone or breastbone and examined with a microscope to find traces of cancerous myeloma cells. A biopsy will provide an estimate of the number of cancer cells, determine their level of activity in the bone marrow, and see how much damage they have already caused to the bone marrow structure. Alternatively, a similar procedure called an aspiration may be performed, where a needle is used to remove bone marrow for testing.

Evaluation of Symptoms

With all of these factors in mind, doctors might also look for other symptoms of myeloma to confirm their diagnosis. Common symptoms of multiple myeloma include anemia, bone pain, broken bones (usually in the spine), weakness and fatigue, excess thirst, frequent infections and fevers, weight loss, nausea, constipation, impaired kidney function, and frequent urination. Though these symptoms may be present in many different conditions, their presence can help doctors accurately diagnose multiple myeloma.

Conclusion

Once a combination of these tests has been completed, a doctor will be prepared to make a myeloma diagnosis. The diagnosis for multiple myeloma is based on the presence of three factors. Firstly, the bone marrow biopsy or aspirate must show that plasma cells make up at least 10 percent of the bone marrow. Secondly, the M protein has to be present in either the blood or urine, and thirdly, there must be signs of damage to the body, such as bone lesions or kidney damage, due to the disease. After myeloma is diagnosed, doctors use either the Durie-Salmon staging system or the International Staging System (ISS) to classify patients into categories depending on the severity of their disease.

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