What are the guidelines for the standard workup for suspected multiple myeloma (MM)?

Updated: May 11, 2021
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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The International Myeloma Workshop developed guidelines for standard investigative workup in patients suspected to have multiple myeloma. These guidelines include the following: [1]

  • 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
  • Magnetic resonance imaging

Consider the risk of acute kidney injury, especially in the setting of contrast medium injection for imaging studies. Take care to limit patients’ exposure and maintain hydration.

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