In Multiple myeloma diagnosis criteria is usually done by chance, since the bone marrow cancer presents few or no discomfort in the early stages. In the majority of patients come to the doctor by a speed very rapid sedimentation, anemia, or frequent infections.
For the diagnosis of multiple myeloma are, first, an x-ray, a magnetic resonance imaging (MRI), a bone marrow biopsy, as well as an analysis of blood and urine. If the doctor suspects that there may be multiple myeloma, can you confirm your suspicion if the following guidelines are given:
- Smear of bone marrow with more than 10% of plasma cells.
- Plasma cell infiltration determined histologically.
- Antibody monoclonal (paraproteins) in blood or urine.
- Destruction of bone tissue at certain points (osteolysis) or osteoporosis (loss of bone density) observed through the proliferation of plasma cells in the bone cell.
If two of these tests are positive, it means that multiple myeloma can be diagnosed. In addition, the following criteria can contribute to the diagnosis of multiple myeloma:
- Hemoglobin in the blood
- Values of calcium and proteins in the blood
- Low values of Defense proteins
In multiple myeloma bone marrow (examination of a sample of tissue) biopsy is an important part of the diagnosis, since it provides essential information on the composition of the blood and the bone lining. The doctor removes a sample of the iliac crest.
It is necessary to perform an x-ray of the skeleton, since multiple myeloma affects both ribs and the vertebrae and the pelvis and femur. Using the results of the magnetic resonance (RM) the doctor can determine how much the tumor has spread by the bone marrow.
International Research Group publishes updated criteria for diagnosing multiple myeloma
The International Working Group on myeloma (IMWG, for its acronym in English) today announced the update of the criteria for the diagnosis of multiple myeloma. Work outlining the new criteria are published in the journal Lancet Oncology. Multiple myeloma is a cancer of the blood that originates in a type of white blood cell, known as plasma cell.
“Our group is composed of more than 180 researchers on myeloma from all over the world, who updated the definition of multiple myeloma for diagnostic purposes to include validated biomarkers, as well as current clinical symptoms that include high levels of calcium in the blood, kidney failure, anemia and bone lesions, says the lead author, Dr. S. Vincent Rajkumar, hematologist of Mayo Clinic.
Dr. Rajkumar explains that multiple myeloma is always preceded sequentially by two asymptomatic conditions: the monoclonal gammopathy of uncertain significance (MGUS, for its acronym in English) and quiescent multiple myeloma (SMM, for its acronym in English).
However, since both the monoclonal gammopathy of uncertain significance and quiescent multiple myeloma are asymptomatic, in the majority of patients not diagnosed disease but until organic damage occurs. “The new criteria of the IMWG allow diagnosing myeloma in asymptomatic patients until there is an organ damage, using validated biomarkers that identify those who suffer from multiple myeloma quiescent and are at risk” extremely high “of moving to multiple myeloma”, says Dr. Rajkumar. “These biomarkers related to the inevitable development of clinical symptoms and are important for diagnosis and early treatment, very important thing for patients”.
Dr. Rajkumar said that other updates to the criteria applied in the diagnosis of multiple myeloma include the use of TAC and PET-TC scans to identify bone lesions that allow to establish a more exact diagnosis and intervene before fractures or other serious problems arise. “We believe that the new criteria shall rectify the impossibility of using the considerable advances in therapy for multiple myeloma until an organic damage. Now, in some patients start therapy early in the course of the disease”.
Dr. Rajkumar notes that several researchers conducted primary research that made it possible to update the criteria and is very grateful for the support of patients and advocates of patients whose stories and opinions provided the impetus for this change in the paradigm.