Which routine lab tests are performed in the workup of multiple myeloma (MM)?

Updated: May 11, 2021
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Routine laboratory tests include the following:

  • Complete blood count and differential
  • Erythrocyte sedimentation rate
  • Comprehensive metabolic panel (eg, levels of total protein, albumin and globulin, BUN, creatinine, uric acid)
  • 24-hour urine collection for quantification of the Bence Jones protein (ie, lambda light chains), protein, and creatinine clearance; proteinuria greater than 1 g/24 hr is a major criterion
  • C-reactive protein
  • Serum viscosity in patients with CNS symptoms, nosebleeds, or very high M protein levels

National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines also recommend the use of serum free light chain assay and plasma cell fluorescence in situ hybridization (FISH) on bone marrow: del 13, del 17p13, t(4;14), t(11;14), t(14;16), t(14;20), 1q21 amplification, 1p deletion as part of the initial diagnostic workup. [2]

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