Multiple Myeloma

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A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

NOTE: Only measurable biomarkers will be reported.

NOTE: Only measurable biomarkers will be reported.

Lactate Dehydrogenase (LD) (LDH)

Elevations in serum lactate dehydrogenase occur from myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary emboli, malignancies, and muscular dystrophy

Monoclonal increases in IgG or IgA are often associated with diseases such as multiple myeloma, lymphomas or leukemia. A monoclonal increase in IgM is commonly associated with Waldenström's macroglobulinemia.

Immunofixation of urine is useful in evaluation of monoclonal free light chains and other monoclonal gammopathies seen in light chain disease, multiple myeloma, Waldenstrom's macroglobulinemia, amyloidosis, and other lymphoproliferative disorders. Increased polyclonal free light chains in urine may be seen in glomerular leak syndromes and in infection or inflammatio

Elevations of IgG, A and/or M are seen in generalized hypergammaglobulinemia, chronic inflammatory conditions and in lymphoproliferative diseases such as multiple myeloma, lymphoma and leukemias. Decreased levels are found in immunodeficiency states, generalized hypogammaglobulinemia and in unrecognized pediatric patients.

For diagnosis of allergic disease. A normal IgE level does not exclude the possible presence of an allergic disorder.

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Increased IgG is associated with acute and chronic inflammations, monoclonal IgG myeloma, autoimmune diseases; decreased IgG is found in selective IgG deficiency, Bruton's Disease, and acquired immune deficiency.

Increased IgM is associated with Waldenström's macroglobulinemia, infectious mononucleosis, viral infections, nephrotic syndrome, and estrogen therapy; decreased IgM is found in selective IgM deficiency, Bruton's Disease, and acquired immune deficiency.

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Immunoglobulin A (IgA)

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Clinical Use

  • Diagnose IgA deficiencies

  • Determine etiology of recurrent infections

  • Diagnose infection

  • Diagnose inflammation

  • Diagnose IgA monoclonal gammopathy

Clinical Background

IgA is the first line of defense for the majority of infections at mucosal surfaces and consists of 2 subclasses. IgA1 is the dominant subclass, accounting for 80% to 90% of total serum IgA and greater than half of the IgA in secretions such as milk, saliva, and tears. IgA2, on the other hand, is more concentrated in secretions than in blood. IgA2 is more resistant to proteolytic cleavage and may be more functionally active than IgA1.

IgA deficiency is the most prevalent isotype deficiency, occurring in 1/400 to 1/700 individuals. Many patients with IgA deficiency are asymptomatic, while others may develop allergic disease, repeated sinopulmonary or gastroenterologic infections, and/or autoimmune disease. Individuals with complete absence of IgA (<5 mg/dL) may develop autoantibodies to IgA after blood or intravenous immunoglobulin infusions and may experience anaphylaxis on repeat exposure. 

Elevated serum IgA levels are associated with infection, inflammation, or IgA monoclonal gammopathy.


Protein Electrophoresis, Random Urine (UPEP)


Total Protein, Protein Electrophoresis, Creatinine

Measurement of the amounts of the different light chain types aids in the diagnosis and monitoring of multiple myeloma, lymphocytic neoplasms, Waldenstrom's macroglobulinemia, and connective tissue diseases, such as systemic lupus erythematosus.

The presence of immunoglobulin light chains (kappa or lambda) on the cell surface is characteristic of clonal proliferation most often seen in multiple myeloma and lymphoproliferative diseases.

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Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.

The major proteins seen in the serum are albumin and globulin-the latter being primarily alpha 1 and alpha 2 globulin, beta globulin and gamma globulin. Albumin accounts for more than 50% of the total serum proteins. The albumin to globulin (A/G) ratio has been used as an index of disease state, however, it is not a specific marker for disease because it does not indicate which specific proteins are altered. The normal A/G ratio is 0.8-2.0. The A/G ratio can be decreased in response to a low albumin or to elevated globulins. Total globulins may be increased in some chronic inflammatory diseases (TB, syphilis) multiple myeloma, collagen disease, and rheumatoid arthritis. Decreased levels are seen in hepatic dysfunction, renal disease and various neoplasms.

Protein electrophoresis is a test that measures specific proteins in the blood. The test separates proteins in the blood based on their electrical charge. The protein electrophoresis test is often used to find abnormal substances called M proteins.

This is a client specific reflex test. Reflex criteria has been pre-defined by the ordering physician. Additional testing will be performed at an additional charge.


The reflex test is 

Urinary total proteins are negligible in health individuals. Concentrations are increased in patients with a wide variety of disease that impair renal function including diabetes, hypertension, Nephritic Syndrome, and drug nephrotoxicity.

The determination of proteinuria is a well established laboratory procedure for the evaluation of renal disease (glomerular, tubular and overflow proteinuria), urinary tract inflammation, orthostatic proteinuria and preeclampsia (a potential complication of pregnancy). A more rapid clinical assessment of proteinuria using a 12-hour specimen enables a faster diagnosis with subsequent intervention in several of the clinical conditions cited above.

Proteinuria, mainly glomerular, is often a manifestation of primary renal disease although transient proteinuria may occur with fevers, thyroid disorders, and in heart disease. In the absence of renal disease, the degree of proteinuria is slight, usually amounting to less than 2 grams per day. In chronic glomerulonephritis and in the nephrotic syndrome including lipoid nephrosis and in some forms of hypertensive vascular disease, protein loss may vary from a few grams to as much as 30 g/day.

In 2021, approximately 34,920 adults in the United States will be diagnosed with multiple myeloma. 

Multiple myeloma is a rare blood cancer that is often fatal. But survival rates are improving steadily over time, and multiple myeloma tests are a huge reason for that.

Diagnosing multiple myeloma can be time-consuming and scary, but the more you know about myeloma and the testing involved, the easier it will be.

If you have signs and symptoms of multiple myeloma and want to know what's next, you're in the right place. Keep reading this guide to learn everything you need to know about multiple myeloma and multiple myeloma tests. 

What is Multiple Myeloma

Multiple myeloma is a blood cancer that forms in your plasma cells. Your plasma cells help fight infections by producing antibodies that can recognize germs and attack them. 

When you have multiple myeloma, your body begins to produce abnormal plasma cells. These plasma cells try to make antibodies just like your normal plasma cells do, and only the difference is these antibodies don't function normally. The abnormal antibodies are monoclonal proteins or M proteins.

You then start to accumulate these abnormal plasma cells and antibodies in your body, leading to multiple myeloma symptoms such as fatigue, bone lesions, and the lack of ability to fight infections.

Types of Multiple Myeloma

There are two main types of multiple myeloma, indolent multiple myeloma and active multiple myeloma. There are also different subtypes of myeloma, categorized by their chromosomal abnormalities.

Indolent multiple myeloma is sometimes called asymptomatic myeloma because it doesn't cause symptoms. For a diagnosis of indolent myeloma, you need to have 10% or more of the blood cells in your bone marrow made up of plasma cells, or an M protein level of 30 g/L or higher in your blood.

Different risk levels predict when indolent myeloma might turn into active myeloma. These risk levels are low, intermediate, and high-risk.

The next type is active multiple myeloma, also known as symptomatic multiple myeloma. People with active multiple myeloma will have symptoms of multiple myeloma along with any of the following:

  • 10% or more of the blood cells in your bone marrow are plasma cells
  • M protein in your blood or urine
  • Anemia, kidney failure, or hypercalcemia
  • A tumor in bone or soft tissue that contains myeloma cells
  • Osteolytic lesions

The Condition MGUS 

monoclonal gammopathy of undetermined significance (MGUS) can be a precursor to developing multiple myeloma in the future. This is a condition where you have a high monoclonal protein count in your blood but no other symptoms.

Usually, MGUS doesn't cause problems, but it can develop into multiple myeloma. For this reason, if you have MGUS, you'll need to have regular checkups to be sure it doesn't progress. 

Risk factors for Multiple Myeloma

While cell mutations cause multiple myeloma, certain factors increase your risk of getting multiple myeloma like:

  • Old age, especially if you're older than 65
  • If you're male
  • If you're African American
  • If you have a sibling or parent with myeloma, your risk increases
  • If you're diagnosed with MGUS 

Causes of Multiple Myeloma

Researchers aren't entirely sure what causes multiple myeloma, but it seems to be related to DNA mutations that alter chromosomes and turn off genes that naturally suppress tumors.

Signs and Symptoms of Multiple Myeloma

Symptoms of multiple myeloma can vary, especially early in the disease process. When you do have symptoms, you can expect:

  • Bone pain around your spine or chest
  • Nausea and loss of appetite
  • Constipation
  • Fatigue
  • Weight loss
  • Extreme thirst
  • Mental fogginess
  • Weakness or numbness
  • Frequent infections
  • Elevated calcium levels

The most common symptoms of multiple myeloma are commonly referred to using the acronym CRAB.

C stands for elevated calcium levels from bones breaking down. R stands for renal (kidney) failure, which occurs from abnormal proteins in the kidneys. A stands for anemia which is caused by the abnormal plasma cells crowding out the healthy cells. And B stands for bone lesions that most commonly occur in the spine and ribs.

Complications of Multiple Myeloma

Multiple myeloma can cause your bones to become weaker, leading to multiple fractures. Myeloma also causes anemia, which means your body doesn't have enough red blood cells. 

You can also experience low platelets in your blood, making it more difficult for your blood to clot. You're also more susceptible to infections and low white blood cells, which weaken your immune system even further.

The M proteins in multiple myeloma can clog your kidneys, causing them not to filter out toxins like they usually would. The build-up eventually leads to kidney failure.

How is Multiple Myeloma Diagnosed

Diagnosing multiple myeloma often happens by accident when you have blood drawn for another reason. Your doctor will ask you questions like:

  • How long you have had symptoms?
  • Are your symptoms becoming worse over time?
  • Does anything improve your symptoms?
  • Does anything make them worse?

Your doctor will order diagnostic tests and blood work. Initial bloodwork typically includes a complete blood count to measure the cells in your blood and kidney function tests to check how your kidneys are functioning.

Other blood and urine tests will be ordered to check if your body is making monoclonal proteins, and if so, how much. 

More examinations include CT Scans and an MRI to check your bones for tumors or damage. And finally, a bone marrow biopsy will determine how many abnormal plasma cells are in your bone marrow.

Lab Tests For Multiple Myeloma

One of the first tests your doctor will order is a complete blood count. A complete blood count will show red blood cells and platelets and give an overall picture of how your immune system functions.

Next, your doctor will want to assess the overall health of your kidneys and other organs by checking a complete metabolic panel. This panel will check your kidney and liver function, as well as your calcium levels.

lactate dehydrogenase level (LDH) is checked as elevations in your LDH can point to certain cancers like myeloma.

Next, an immunofixation urine test (IFE) is useful in evaluating the number of monoclonal proteins that collect in your urine which is one of the main signs of myeloma.

Your doctor will also want to check the levels of your immunoglobulins by ordering an immunoglobulin panel (IgA, IgG, IgM). Elevations of these immunoglobulins are found in certain cancers like multiple myeloma.

total protein and electrophoresis is a blood test the measures specific proteins in the blood. In this test, proteins are separated by their electrical charge, and it's often used to detect if you have monoclonal proteins in your blood.

Other tests that help with the treatment, diagnosis, and type of myeloma you have include the kappa/lambda light chains lab test. This test measures how many immunoglobulin-free light chains you have. If these levels are high, you have what's called a light chain type of myeloma. The surface light chains test is another way to detect how many light chains are on the cell's surface.

beta-2-microglobulin lab test measures another protein made by abnormal myeloma cells. This protein in itself doesn't cause problems, but in multiple myeloma, high levels of this may indicate a poor prognosis.

FAQS about Multiple Myeloma

Common questions about multiple myeloma usually start with asking if there is a cure. There is no cure for multiple myeloma, but treatments are improving every day. Life expectancy is also increasing, now extending over five years past diagnosis. And some people beat the odds, living another 10 to 20 years or more.

Are you wondering what happens if you are diagnosed with indolent myeloma? The good news is you only have a 10% risk each year of it progressing to active multiple myeloma. And people can have indolent myeloma for many years and never need treatment.

Do you need to see a specialist who explicitly treats multiple myeloma? Yes, it's a good idea to find an oncologist who focuses on treating and researching multiple myeloma. Specialists have better knowledge of new research, treatments, and clinical trials.


A great resource to check out is the National Comprehensive Cancer Network. This network is not for profit and combines 31 cancer centers devoted to research and education. You can find updates on webinars, conferences, and updated multiple myeloma guidelines for patients on this site. 

Multiple Myeloma Tests at Ulta Lab Tests

Ulta Lab Tests offers highly accurate and reliable tests, allowing you to make the best decisions for your health. Wonder what is so amazing about Ulta Lab Tests? We offer:

  • Secure and confidential results
  • No need for any health insurance
  • No need for a physician's referral
  • Affordable pricing on all tests
  • A 100% satisfaction guarantee

Order your multiple myeloma lab tests today, and your results will be provided to you securely within 24 to 48 hours in most cases.

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