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1. Clinical assessment
A detailed history should focus on bone pain, fatigue, and recurrent infections. Physical examination evaluates signs of anemia, skeletal tenderness, and other findings suggestive of systemic involvement.
2. Blood tests
Core tests include complete blood count and serum biochemistry, as well as serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) to detect anemia, renal dysfunction, and the presence and type of M-protein.
3. Urine tests
A 24-hour urine collection with quantification of monoclonal light chains and urine immunofixation is important for detecting urinary M-protein excretion, particularly in light-chain myeloma.
4. Bone marrow evaluation
Bone marrow aspiration and biopsy are the diagnostic gold standard. They quantify the plasma cell burden and confirm clonality, providing decisive evidence for diagnosis and risk stratification.
5. Imaging studies
Skeletal imaging—such as X-ray, CT, MRI, or PET-CT—is used to evaluate osteolytic lesions and soft tissue involvement. Low-dose whole-body CT is more sensitive than conventional radiographs for detecting bone destruction.
6. Cytogenetic and molecular testing
Fluorescence in situ hybridization (FISH) identifies abnormalities such as IGH translocations and del(17p), which are critical for prognostic assessment and treatment planning.
7. Differential diagnosis
Multiple myeloma must be differentiated from monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma, and other plasma cell dyscrasias using integrated clinical, laboratory, and marrow findings.
8. Staging and prognostic assessment
Staging systems such as Durie–Salmon, ISS, and Revised ISS (R-ISS), together with cytogenetic risk features and LDH levels, are used to estimate prognosis and guide therapeutic intensity.
9. Self-monitoring considerations
Patients should pay attention to persistent bone pain, fatigue, foamy urine, edema, and recurrent infections, and seek medical evaluation promptly if these symptoms occur or worsen. Regular monitoring of body weight and temperature can help identify early deterioration.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that multiple myeloma is a malignant plasma cell disorder that can cause severe skeletal destruction, renal failure, and recurrent infections, posing a serious threat to life. Because presentations are heterogeneous and diagnosis can be complex, a multidisciplinary approach and standardized diagnostic workup are essential. Early symptom recognition, comprehensive testing, and timely confirmation of diagnosis are key to improving prognosis; individuals at elevated risk should seek medical evaluation as early as possible when suspicious symptoms arise.
1. Clinical assessment
A detailed history should focus on bone pain, fatigue, and recurrent infections. Physical examination evaluates signs of anemia, skeletal tenderness, and other findings suggestive of systemic involvement.
2. Blood tests
Core tests include complete blood count and serum biochemistry, as well as serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) to detect anemia, renal dysfunction, and the presence and type of M-protein.
3. Urine tests
A 24-hour urine collection with quantification of monoclonal light chains and urine immunofixation is important for detecting urinary M-protein excretion, particularly in light-chain myeloma.
4. Bone marrow evaluation
Bone marrow aspiration and biopsy are the diagnostic gold standard. They quantify the plasma cell burden and confirm clonality, providing decisive evidence for diagnosis and risk stratification.
5. Imaging studies
Skeletal imaging—such as X-ray, CT, MRI, or PET-CT—is used to evaluate osteolytic lesions and soft tissue involvement. Low-dose whole-body CT is more sensitive than conventional radiographs for detecting bone destruction.
6. Cytogenetic and molecular testing
Fluorescence in situ hybridization (FISH) identifies abnormalities such as IGH translocations and del(17p), which are critical for prognostic assessment and treatment planning.
7. Differential diagnosis
Multiple myeloma must be differentiated from monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma, and other plasma cell dyscrasias using integrated clinical, laboratory, and marrow findings.
8. Staging and prognostic assessment
Staging systems such as Durie–Salmon, ISS, and Revised ISS (R-ISS), together with cytogenetic risk features and LDH levels, are used to estimate prognosis and guide therapeutic intensity.
9. Self-monitoring considerations
Patients should pay attention to persistent bone pain, fatigue, foamy urine, edema, and recurrent infections, and seek medical evaluation promptly if these symptoms occur or worsen. Regular monitoring of body weight and temperature can help identify early deterioration.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that multiple myeloma is a malignant plasma cell disorder that can cause severe skeletal destruction, renal failure, and recurrent infections, posing a serious threat to life. Because presentations are heterogeneous and diagnosis can be complex, a multidisciplinary approach and standardized diagnostic workup are essential. Early symptom recognition, comprehensive testing, and timely confirmation of diagnosis are key to improving prognosis; individuals at elevated risk should seek medical evaluation as early as possible when suspicious symptoms arise.