How is myeloma diagnosed?

Your doctor will examine you and refer you for tests to make a diagnosis. The test results will help them recommend a treatment plan for you.

Blood tests

Your doctor will take a blood sample to see how well your blood and kidneys are working, and to check your general health.
The main test blood test used is called serum protein electrophoresis. This measures the level of paraprotein in you blood, a protein produced by myeloma cells.

Another blood test called the serum free light chain assay may be used to check for a form of paraprotein known as free light chains.

Urine test

A urine test may be used to check for the Bence Jones protein, which is the light chain part of paraprotein and does not show up in blood tests. About one-third of people with myeloma make enough Bence Jones protein for it to be measurable in the urine.

Bone marrow biopsy

Blood cells develop in your bone marrow, so your doctor will want to check a sample of your bone marrow for signs of myeloma. A sample from your bone marrow is taken with a needle to remove a small amount of fluid (aspirate) or a small amount of bone and marrow (biopsy). You will be given a local anaesthetic to numb the area, pain relief or light sedation to help you feel relaxed.

Imaging tests

You will usually have at least one of the following to check if the myeloma has spread.

• chest x-ray;
• CT (computerised tomography) scan;
• PET (positron emission tomography)-CT scan; or
• MRI (magnetic resonance imaging).

Cytogenetic tests

Using the bone marrow biopsy, cytogenetic tests look for changes in the chromosomes within the myeloma cells, which are different to the normal cells in the body. This can help determine treatment options.