Fast Five Quiz: Are You Prepared to Confront Multiple Myeloma?

Emmanuel C Besa, MD; Dhaval Shah, MD


January 14, 2022

The International Myeloma Workshop developed guidelines for standard investigative workup in patients suspected to have multiple myeloma. These guidelines include the following:

  • Serum and urine assessment for monoclonal protein (densitometer tracing and nephelometric quantitation; immunofixation for confirmation)

  • Serum-free light chain assay (in all patients with newly diagnosed plasma cell dyscrasias)

  • Bone marrow aspiration and/or biopsy

  • Serum beta(2)-microglobulin, albumin, and lactate dehydrogenase measurement

  • Standard metaphase cytogenetics

  • Fluorescent in situ hybridization

  • Skeletal survey

  • MRI

MRI is useful in detecting thoracic and lumbar spine lesions, paraspinal involvement, and early cord compression. MRI can depict spinal abnormalities in patients with asymptomatic gammopathies even when radiographic studies are normal. Therefore, symptomatic patients should be evaluated with MRI for a clear view of the spinal column and to assess the integrity of the spinal cord.

Learn more about the workup of multiple myeloma.


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