Last reviewed: June 2018
Last updated: May  2018

Summary

Definition

History and exam

Key diagnostic factors

  • anaemia
  • bone pain
  • monoclonal gammopathy of undetermined significance (MGUS)

Other diagnostic factors

  • infections
  • fatigue
  • renal impairment

Risk factors

  • monoclonal gammopathy of undetermined significance (MGUS)
  • abnormal free light-chain ratio
  • family history of MM
  • radiation exposure
  • petroleum products exposure

Diagnostic investigations

1st investigations to order

  • serum/urine electrophoresis
  • skeletal survey
  • whole-body, low-dose computed tomography (WBLD-CT)
  • serum free light-chain assay
  • bone marrow aspirate and biopsy
  • serum calcium
  • FBC
  • creatinine, urea
  • serum beta2-microglobulin
  • serum albumin
Full details

Investigations to consider

  • whole-body MRI
  • 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET)/FDG-PET-CT
  • C-reactive protein (CRP)
  • LDH
  • cytogenetics and fluorescence in situ hybridisation analysis
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Research Fellow

Massachusetts General Hospital

Harvard Medical School

Boston

MA

Disclosures

LS declares that she has no competing interests.

Sonia Vallet

Fellow in Hematology and Oncology

National Center for Tumor Disease (NCT)

Heidelberg University

Heidelberg

Germany

Disclosures

SV declares that she has no competing interests.

Noopur Raje

Director of Multiple Myeloma Program

Massachusetts General Hospital

Harvard Medical School

Boston

MA

Disclosures

NR has consulted for Celgene, Takeda, Amgen, and Novartis and has received research funds from Eli Lilly and AstraZeneca.

Peer reviewers VIEW ALL

Associate Professor of Medicine

Mayo Clinic

Rochester

MN

Disclosures

SK declares that she has no competing interests.

Institute of Cancer Research

Sutton

Surrey

UK

Disclosures

FD declares that she has no competing interests.

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