At Roswell Park, board-certified hematopathologists (pathologists who specialize in identifying blood cancers) diagnose and classify multiple myeloma and other blood cancers using the most advanced technology. Radiologists and nuclear medicine doctors evaluate images of your whole body. Geneticists and flow cytometry experts analyze your myeloma cells to estimate prognosis and guide therapy. Our specialists work closely with the Multiple Myeloma clinical team to provide fast, complete test results.
If you are being evaluated to see if you have multiple myeloma, you may undergo these tests:
- A physical exam
- Blood tests: The lab tests look for high levels of specific proteins in the blood. A complete blood check will also count the number of white and red blood cells and platelets. Your calcium and creatinine blood levels will be measured.
- Urine tests: The lab will test your urine, collected over a 24-hour period, to check for Bence Jones protein (light chains) and evaluate your kidney function. If you have a high level of this protein, it can clog and damage your kidneys, so doctors will need to keep an eye on how well your kidneys are working.
- Magnetic resonance imaging (MRI), positron emission tomography and computed tomography (PET-CT), and low-dose, whole-body CT, to find out whether there are any holes or plasma cell accumulations in the bones. In 2019 the International Myeloma Working Group (IMWG) introduced new guidelines recommending these techniques over conventional X-ray, because they provide sharper images and more accurate diagnosis and monitoring of patients with multiple myeloma and other plasma-cell disorders. The recommendations were written by a team of IMWG experts led by Jens Hillengass, MD, Chief of Myeloma at Roswell Park. It’s hoped that the new guidelines, which were in place early on for Roswell Park patients, will allow for earlier treatment and longer life.
- Biopsy: A bone marrow biopsy is the only sure way to find out whether too many plasma cells are present in your bone marrow. There are two ways your doctor can obtain bone marrow for testing. Some people will have both procedures during the same visit:
- Bone marrow aspiration: The doctor uses a hollow needle to remove samples of bone marrow.
- Bone marrow biopsy: The doctor uses a hollow needle to remove a small piece of bone and bone marrow.
- Cytogenetic analysis of your multiple myeloma: The team of doctors will examine your multiple myeloma at the genetic level to further assess the risk category of your disease.
- Flow cytometric analysis of your myeloma cells: Our flow cytometry lab examines the surface of your myeloma cells to tell them apart from healthy plasma cells.
Roswell Park continually adds advanced technology to its toolkit to provide fast, early and accurate detection and diagnosis of multiple myeloma.
Diagnostic Clinical Trials
Clinical trials are studies of new and promising ways to detect, prevent or treat cancer. They generate information that can improve cancer care.
At Roswell Park, you may be offered the chance to participate in a clinical trial of a new way of diagnosing or monitoring your disease. (You may also be offered the opportunity to take part in clinical trials for treating your disease.) Please visit our Clinical Trials page for information about current trials. We will always explain in detail, and in writing, the reason for these additional tests, and the research questions we hope they will answer. You may choose not to participate. The medical care (other than the trial itself) you receive from us will be the same whether or not you enroll in a clinical trial.
Diagnostic clinical trials may involve additional imaging procedures, blood or bone marrow samples, or biopsies, over and above the tests you already receive to monitor your disease. Some of these tests may take place at different times and locations.