Diagnosing and Staging Myeloma

To accurately diagnose myeloma, the City of Hope care team may need to perform several tests to determine how advanced the disease is. In addition to a routine physical exam and taking a patient’s medical and family history information, City of Hope staff may also perform biopsies and imaging tests.
  • Complete blood count - This basic test obtains an accurate count of all the different types of blood cells, which can help detect myeloma because it can cause a decrease in red blood cells, white blood cells and platelets.
  • Blood chemistry test - The blood sample is also checked for certain substances, such as calcium, indicated presence of multiple myeloma, as well as bone or organ damage associated with this cancer.
  • Bone marrow aspirate and biopsy - Bone marrow tissue is extracted and examined by a pathologist under a microscope to determine if the suspected tissue is cancerous. Generally, if a biopsy reveals that more than 10 percent of the marrow is made up of plasma cells, it is indicative of bone marrow plasmacytosis—a determining diagnostic factor of myeloma.
  • 24-hour urine test - Urine is collected for 24 consecutive hours and evaluated for substances that can be indicative of multiple myeloma and associated bone or organ damage.
  • X-ray - A skeletal X-ray is done to determine and locate bone lesions and tumors due to multiple myeloma.
Stages of Myeloma
To properly plan for treatment, multiple myeloma is staged in accordance to how advanced the cancer is. This is primarily done by measuring beta-2 microglobulin and albumin levels in the bloodstream.
The stages of multiple myeloma are:
  • Stage I: beta-2-microglobulin level is lower than 3.5 mg/L and albumin level is 3.5 g/dL or higher.
  • Stage II: beta-2-microglobulin level is lower than 3.5 mg/L and the albumin level is lower than 3.5 g/dL OR beta-2-microglobulin level is between 3.5 mg/L and 5.4 mg/L
  • Stage III: beta-2-microglobulin level is 5.5 mg/L or higher.

If you have been diagnosed with myeloma or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.