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Diagnosing multiple myeloma
Multiple myeloma guidelines and testing
Multiple myeloma can be easily overlooked due to nonspecific and vague symptoms, such as fatigue and back and bone pain.1
With Labcorp as your partner, you can access simple, guideline-recommended blood tests for multiple myeloma that lead to earlier detection and expedite patient referrals for improved diagnosis. This can result in more optimal treatment options and better patient outcomes.
A proactive approach to early detection
The average patient will see their primary care provider three times with signs and symptoms before multiple myeloma is suspected. This delay in diagnosis may explain why almost 30% of patients with multiple myeloma present in urgent care or emergency settings.2
With delays in diagnosis come worsening patient outcomes and clinical complications, including increased risk of3:
- Bone disease
- Anemia
- Renal impairment
- Neurological disease
- Recurrent infections
Early diagnosis and referrals to a hematologist/oncologist to initiate treatment are associated with better outcomes.
| Complication | 0-3 months (Sample group 28) | 3-6 months (Sample group size 21) | > 6 months (Sample group size 43) |
|---|---|---|---|
| Infection | 2 | 1 | 5 |
| Neurological | 3 | 1 | 3 |
| Renal | 6 | 4 | 24 |
| Bone | 7 | 8 | 26 |
| Anemia | 2 | 8 | 40 |
Combining recognition of early signs
and symptoms with early testing
Spotting symptoms like bone pain, fatigue, bruising, bleeding and lab abnormalities (anemia, elevated creatinine, hypercalcemia, elevated total protein, etc.)1 is just the first step in diagnosing multiple myeloma. To help you find answers for your patients, Labcorp’s three multiple myeloma tests (serum protein electrophoresis [SPEP], serum free light chain [sFLC], serum immunofixation electrophoresis [sIFE]) provide accurate and sensitive detection of pathogenic markers of the disease.
Early testing can improve outcomes
Early testing can improve outcomes (patient timeline):
- Patient develops symptoms
- Patient seeks primary care
- Assess clinical symptoms
- Basic lab testing
- Monoclonal protein testing
- SPEP + sFLC and sIFE testing
- Results
- If normal, explore other causes
- If abnormal, refer to hematologist / oncologist
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Discover a primary care approach to confronting this deceptive cancer and making a difference with early diagnosis
Early testing improves diagnostic accuracy.
At Labcorp, we offer a Multiple Myeloma Profile in one convenient order code for the three guideline-recommended tests (SPEP, sIFE and sFLC) to support the diagnosis of multiple myeloma and appropriate referral to hematology/oncology.
Recognizing risk factors for multiple myeloma
Identifying the symptoms of multiple myeloma can be challenging when the signs are nonspecific.
When you know which patient populations are most at risk, you can detect multiple myeloma sooner and, if needed, initiate treatment earlier.
Risk factors for multiple myeloma include1,4-5:
- Increasing age
- Male sex
- Race (especially African American and Black ethnicity)
- Family history of multiple myeloma
- Personal history of a monoclonal gammopathy of undetermined significance (MGUS)
How to recognize signs and symptoms of multiple myeloma
- Fatigue 32%
- Bone Pain 58%
- Total CRAB manifestions of MM
- C: Hypercalcemia 13%
- R: Renal insufficiency 48%
- A: Anemia 73%
- B: Lytic Bone Lesions 67%
Did you know?
Multiple myeloma incidence is >2 fold higher in African American
and Black people than in white people.4
| Multiple Myeloma Diagnostic Algorithm | % Diagnostic Sensitivity |
|---|---|
| SPEP alone | 88 |
| Freelite® sFLC alone | 97 |
| SPEP, sFLC and sIFE | > 99 |
Guideline-recommended diagnostic
testing for multiple myeloma
To achieve high diagnostic sensitivity when testing for multiple myeloma and other plasma cell disorders, guidelines now recommend the use of sFLC testing in combination with SPEP and sIFE.6 Together, these assays demonstrate >99% diagnostic sensitivity for myeloma, setting your patients on the most reliable path to diagnosis.7
Historically, when diagnosing multiple myeloma, providers used SPEP alone to detect and measure monoclonal proteins.
Labcorp’s three-in-one diagnostic test for multiple myeloma can help you meet your patients’ needs.
Reach out to a Labcorp representative to learn more about our multiple myeloma testing options.
References:
- Mikhael J, Bhutani M, Cole CE. Multiple Myeloma for the Primary Care Provider: A Practical Review to Promote Earlier Diagnosis Among Diverse Populations. Am. J. Med. 2023; 136(1):33-41. https://doi.org/10.1016/j.amjmed.2022.08.030.
- Hossain MI, Hampson P, Nowell C, et al. An in Depth Analysis of Factors Contributing to Diagnostic Delay in Myeloma: A Retrospective UK Study of Patients Journey from Primary Care to Specialist Secondary Care. Blood. 2021; 138(Supplement 1):3007. https://doi.org/10.1182/blood-2021-150848.
- Kariyawasan CC, Huges DA, Jayatillake MM, Mehta AB. Multiple Myeloma: Causes and Consequences of Delay in Diagnosis. QJM Int. J. Med. 2007; 100(10):635-640. https://doi.org/10.1093/qjmed/hcm077.
- National Cancer Institute. Surveillance, Epidemiology, and End Results Program. seer.cancer.gov. Updated June 8, 2023. Accessed July 14, 2023. https://seer.cancer.gov/statistics-network/explorer/
- Schinasi LH, Brown EE, Camp NJ, et al. Multiple myeloma and family history of lymphohaematopoietic cancers: Results from the International Multiple Myeloma Consortium. Br J Haematol. 2016; 175(1):87-101. doi: 10.1111/bjh.14199. Epub. 2016 Jun 22. PMID: 27330041; PMCID: PMC5035512.
- Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group Updated Criteria for the Diagnosis of Multiple Myeloma. Lancet Oncol. 2014; 15(12):e538–e548. https://doi.org/10.1016/S1470-2045(14)70442-5.
- Katzmann JA, Kyle RA, Benson J, et al. Screening Panels for Detection of Monoclonal Gammopathies. Clin. Chem. 2009; 55(8):1517–1522. https://doi.org/10.1373/ clinchem.2009.126664.