Summary
Definition
History and exam
Key diagnostic factors
- anemia
- bone pain
- monoclonal gammopathy of undetermined significance (MGUS)
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
- CBC
- creatinine, BUN
- serum beta2-microglobulin
- serum albumin
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 hybridization analysis
Treatment algorithm
Contributors
Authors
Research Fellow
Massachusetts General Hospital
Harvard Medical School
Boston
MA
Disclosures
LS declares that she has no competing interests.

Fellow in Hematology and Oncology
National Center for Tumor Disease (NCT)
Heidelberg University
Heidelberg
Germany
Disclosures
SV declares that she has no competing interests.

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
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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