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Multiple Myeloma

  • Posted: 11/20/2008

Diagnosis

Doctors sometimes find multiple myeloma after a routine blood test. More often, doctors suspect multiple myeloma after an x-ray for a broken bone. Usually though, patients go to the doctor because they are having other symptoms.

To find out whether such problems are from multiple myeloma or some other condition, your doctor may ask about your personal and family medical history and do a physical exam. Your doctor also may order some of the following tests:

  • Blood tests: The lab does several blood tests:
    • Multiple myeloma causes high levels of proteins in the blood. The lab checks the levels of many different proteins, including M protein and other immunoglobulins (antibodies), albumin, and beta-2-microglobulin.
    • Myeloma may also cause anemia and low levels of white blood cells and platelets. The lab does a complete blood count to check the number of white blood cells, red blood cells, and platelets.
    • The lab also checks for high levels of calcium.
    • To see how well the kidneys are working, the lab tests for creatinine.
  • Urine tests: The lab checks for Bence Jones protein, a type of M protein, in urine. The lab measures the amount of Bence Jones protein in urine collected over a 24-hour period. If the lab finds a high level of Bence Jones protein in your urine sample, doctors will monitor your kidneys. Bence Jones protein can clog the kidneys and damage them.
  • X-rays: You may have x-rays to check for broken or thinning bones.An x-ray of your whole body can be done to see how many bones could be damaged by the myeloma.
  • Biopsy: Your doctor removes tissue to look for cancer cells. A biopsy is the only sure way to know whether myeloma cells are in your bone marrow. Before the sample is taken, local anesthesia is used to numb the area. This helps reduce the pain. Your doctor removes some bone marrow from your hip bone or another large bone. A pathologist uses a microscope to check the tissue for myeloma cells. There are two ways your doctor can obtain bone marrow. Some people will have both procedures during the same visit:
    • Bone marrow aspiration: The doctor uses a thick, hollow needle to remove samples of bone marrow.
    • Bone marrow biopsy: The doctor uses a very thick, hollow needle to remove a small piece of bone and bone marrow.

You may want to ask your doctor these questions before having a bone marrow aspiration or biopsy:

  • Will you remove the sample of bone marrow from the hip or from another bone?
  • Where will I go for this procedure?
  • Will I have to do anything to prepare for it?
  • How long will it take? Will I be awake?
  • Will it hurt? What will you do to prevent or control the pain?
  • Are there any risks? What are the chances of infection or bleeding after the procedure?
  • How long will it take me to recover?
  • How soon will I know the results? Who will explain them to me?
  • If I do have multiple myeloma, who will talk to me about next steps? When?