What are the National Comprehensive Cancer Network (NCCN) guidelines for the workup of multiple myeloma (MM)?

Updated: Mar 06, 2020
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The NCCN guidelines recommend the following diagnostic studies [2] :

  • Complete blood count (CBC), differential, platelet count
  • Serum blood urea nitrogen (BUN), creatinine, electrolytes, albumin, calcium, uric acid levels
  • Serum LDH and beta-2 microglobulin
  • Creatinine clearance (calculated or measured)
  • Serum quantitative immunoglobulins, serum protein electrophoresis (SPEP), serum immunofixation electrophoresis (SIFE)
  • 24-h urine for total protein, urine protein electrophoresis (UPEP), urine immunofixation electrophoresis (UIFE)
  • Serum FLC assay
  • Whole-body low-dose CT scan or FDG PET/CT
  • Unilateral bone marrow aspirate and biopsy, including bone marrow immunohistochemistry and/or multi-parameter flow cytometry
  • Metaphase cytogenetics on bone marrow
  • Plasma cell FISH on bone marrow: del 13, del 17p13, t(4;14), t(11;14), t(14;16), t(14;20), 1q21 amplification, 1p deletion

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