Pre-Myeloma Diagnosis

Sadly, from a diagnosis standpoint, pre-myeloma conditions are viewed as a sort of red-headed stepchild to multiple myeloma. Meaning, oncology focuses on tests for monoclonal proteins and how they might change the patient’s body chemistry that is the focus.

In fact, many pre-myeloma patients find their pre-cursor disease by accident while looking for some other health problem. My point is that diagnostic testing for SPB, MGUS and SMM are all tests common for testing multiple myeloma.

Fortunately, the diagnostic information gained through mm testing is the same for pre-myeloma diagnostic testing. It is possible however, that your oncologist will prescribe fewer tests gathering less information.

Read the posts linked below to learn more about pre-myeloma diagnostics

Are you struggling with a diagnosis of a single plasmacytoma of bone, monoclonal gammopathy of undetermined significance or smoldering multiple myeloma? Scroll down the page, post a question or comment and I will reply to you ASAP.

To Learn About Pre-Myeloma (SPB, MGUS, MGCS, SMM), diagnostics, symptoms and therapies- click now

Thanks,

David Emerson

MM Survivor
MM Cancer Coach
Director PeopleBeatingCancer

Multiple Myeloma Diagnosis and Stages

“Multiple Myeloma Blood Tests

Blood tests are essential to accurate diagnosis of this complex disease. They can help your hematologist identify and measure many things to indicate type and stage of disease, including:

Albumin, a protein in the blood which, when low, can identify more aggressive disease
Beta-2-microglobulin, a protein made by myeloma cells
Calcium, which is in higher levels in the blood when bone is breaking down
Complete blood count, levels of red cells, white cells and platelets
Genetic abnormalities of the cancer, which helps guide treatment decisions
Lactate dehydrogenase (LDH), which indicates tissue damage and active myeloma
Kidney function tests
M protein in the blood, a hallmark of multiple myeloma

Bone Marrow Biopsy

Your team may order a bone marrow biopsy to check the cells in the bone marrow, where multiple myeloma starts. For a bone marrow biopsy, a specialist uses a long, thin need to take a small sample of bone marrow. The sample usually comes from the hip bone. Most patients receive local anesthesia to prevent pain at the needle site, sometimes with a sedative to help them relax.

Our pathologists examine the cells under a microscope to identify myeloma cells and determine how many are present. Our pathologists also perform tests to identify certain characteristics in cells to help determine the best treatment options.

Imaging Tests

Your hematologist may order imaging tests to look for cancer in the body or to identify damage to bones or organs. Imaging tests include X-rays, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and positron emission tomography (PET).

Understanding the Results of Multiple Myeloma Diagnostic Testing

After testing, our multiple myeloma team (or pre-myeloma team) which consists of hematologists, oncologists and pathologists meet to discuss your results. This meeting ensures that we have all of the information we need for an accurate diagnosis.

Then our physicians and nurse practitioners meet with you, taking time to educate you about the diagnosis, including:

Test results
Classification and stage of multiple myeloma
Next steps for treatment
Prognosis
Questions you or your loved ones have

What Is Multiple Myeloma Staging?

If tests indicate you have multiple myeloma/pre-myeloma, our hematologists (blood cancer experts) determine the stage of cancer. The stage ranges from stage I to III.

Test results could indicate that you have a condition that has not yet developed into multiple myeloma but could progress:

Monoclonal gammopathy of undetermined significance (MGUS): There is a small amount of M protein (an antibody released by multiple myeloma cells) in the blood. But there are no other signs of multiple myeloma diagnosis (for example, a tumor or symptoms).
Solitary (isolated) plasmacytoma: There is a single myeloma tumor somewhere in the body. But there are no signs of anemia, kidney damage or further disease.
Smoldering (asymptomatic) multiple myeloma: Low levels of M protein are present in the blood, but there are few to no symptoms.

Depending on classification and stage, your team may suggest multiple myeloma treatment. Or they may recommend active surveillance, a “watch and wait” strategy to monitor you closely until symptoms appear or change.

Getting a Second Opinion on Your Diagnosis

If you already have a blood cancer diagnosis, you may want to meet with a specialist for a second opinion…”

From myeloma precursor disease to multiple myeloma: New diagnostic concepts and opportunities for early intervention

“Since (pre-myeloma) MGUS was first described over 30 years ago, the definition of the entity has evolved. Today, three distinct clinical MGUS subtypes have been defined:

non-IgM (IgG or IgA) MGUS,
IgM MGUS,
and light chain MGUS.

Each clinical MGUS subtype is characterized by unique intermediate stages and progression events…

Furthermore, MGUS has confirmed and reported associations with numerous diseases that are commonly encountered in clinical practice such as osteoporosis and venous thrombosis.(4) Given the fact that MGUS is easily detected in peripheral blood and it can be monitored noninvasively, MGUS represents a readily accessible model to study the conversion of premalignancy to malignancy.(5)…

A more advanced premalignant stage of plasma cell proliferation in non-IgM MGUS is termed smoldering myeloma and is characterized by a much higher risk of progression to multiple myeloma (on average, about 10% per year during the first 5 years of follow-up).(12)…

Recently, a new disease entity termed “light chain MGUS” was defined. It represents the premalignant precursor of a subtype of multiple myeloma called “light chain multiple myeloma” which accounts for almost 20% of all new multiple myeloma cases.(18) The equivalent of smoldering myeloma and smoldering Waldenström’s macroglobulinemia in the spectrum of light chain monoclonal gammopathies is called idiopathic Bence Jones proteinuria (Table 1).(19, 20)…

It should be emphasized that in patients diagnosed with clonal proliferation of plasma cells consistent with a precursor state, the biology and natural history is very different compared with patents diagnosed with multiple myeloma. Importantly, patients with a precursor state should be reassured rather than labeled as having a cancer…

The Mayo Clinic model focuses largely on serum protein abnormalities. For MGUS patients, the following features are considered as adverse risk factors:

non-IgG isotype,
M-protein concentration ≥1.5 g/dL,
and an abnormal serum free light chain (FLC)-ratio (normal reference 0.26-1.65) (Figure 2) (25).

Diagnosed with SMM, SPB, or MGUS?

Pre-Myeloma Diagnosis

Multiple Myeloma Diagnosis and Stages

Bone Marrow Biopsy

Imaging Tests

Understanding the Results of Multiple Myeloma Diagnostic Testing

What Is Multiple Myeloma Staging?

Getting a Second Opinion on Your Diagnosis

From myeloma precursor disease to multiple myeloma: New diagnostic concepts and opportunities for early intervention

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