How Do You Rule Out Multiple Myeloma?
The symptoms of multiple myeloma overlap the symptoms of other diseases. So, it is important to apply various diagnostic tests to rule out the presence of multiple myeloma and start treatment for the actual disease.
How Do You Rule Out Multiple Myeloma?
Multiple myeloma is the cancer of plasma cells and difficult disease to diagnose. The diagnostic test of multiple myeloma and the markers of the multiple myeloma are similar to various other diseases; thus, it is important to exclude the presence of multiple myeloma and to precisely diagnose the disease due to which the symptoms are occurring. When the physician suspects multiple myeloma due to the occurrence of various symptoms, his suspicion should be clear off with the help of various diagnostic techniques which may either indicate the presence or absence of multiple myeloma. Following are the various tests to rule out the presence of multiple myeloma:
Urine Test- Urine function test is done of the important criteria to be evaluated in multiple myeloma. Multiple myeloma significantly affects the kidney function and thus normal urine function test at least reduce the chances of multiple myeloma, if not conclusively exclude the presence of the condition. Further, the absence of Bence Jones protein also increases the probability of the absence of multiple myeloma. (1)
Blood Test- As the multiple myeloma is directly associated with the blood as it is the cancer of plasma cells, blood tests play a significant role in ruling out the presence of multiple myeloma. These blood tests may help in reducing the probability of the condition and when the diagnostic results do not fit in the criteria for the presence of multiple myeloma, the presence may be ruled out. One of the important parameter to evaluate in multiple myeloma is the M-protein which is found in the blood and urine of multiple myeloma patients. Absence of this protein in the patient may help in ruling out the presence of multiple myeloma. Further, the multiple myeloma also affects the kidney, absence of Beta-2 Microglobulin and C - reactive protein in the blood also provide valuable information about the absence of multiple myeloma; M protein in one of the major criteria for evaluation of multiple myeloma. (2)
Plasmacytoma- Presence of plasmacytoma is one of the major criteria of multiple myeloma. It is the presence of one lesion in the bone. Absence of plasmacytoma also helps in ruling out the presence of multiple myeloma. (3)
Absence Of High Level Of IgG And IgA Antibodies- In almost 60-70% of the cases of multiple myeloma, there is an increase in the level of IgG antibodies due to high production by cancer cells. In about 20% of the cases, the level of IgA was significantly higher than normal. Thus, the normal level of these two antibodies may indicate the absence of multiple myeloma.
Plasma Cells- Concentration of the plasma cells in the bone marrow also helps in ruling out multiple myeloma. More than 30% of the plasma cells in the bone marrow is the major criteria for multiple myeloma while the presence of plasma cells in the concentration 10%-30% is the minor criteria. The evaluation of the presence or absence of multiple myeloma can be done by analyzing the level of plasma cells in the bone marrow. The plasma cells are analyzed with the help of bone marrow biopsy in which a small part of the bone marrow is taken for evaluation. This is one of the conclusive methods to rule out the presence of multiple myeloma. (4)
Osteolytic Lesions- Through the imaging techniques, the osteolytic lesions are evaluated. Presences of osteolytic lesions are the minor criteria for multiple myeloma.
Various major and minor criteria are identified for the diagnosis of multiple myeloma. These criteria help in ruling out the presence of this condition. Criteria include the concentration of plasma cells in bone marrow, osteolytic lesions, M-protein in blood and urine and plasmacytoma.
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