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Baseline testing is required to:
- Determine the exact diagnosis:
- Monoclonal Gammopathy linked to another medical condition
- Monoclonal Gammopathy of Undetermined Significance (MGUS)
- Smoldering myeloma: low risk
- Smoldering myeloma: high risk
- Active myeloma for which systemic anti-myeloma treatment is recommended.
- To form the basis for the selection of the most appropriate anti-myeloma treatment and supportive care as well as provide a comprehensive baseline to adequately monitor response to treatment. Response to treatment is assessed by comparisons with baseline clinical features and laboratory test results.
- Recommended baseline tests:
- The International Myeloma Foundation provides several documents which summarize laboratory testing.
Click to view and/or download the slides for Step 2. ASH 2011 presentations that address STEP 2
REFERENCES
©2011 International Myeloma Foundation
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BONE MARROW BIOPSIES
Bone marrow biopsies are performed routinely to diagnose myeloma. They are also used for periodic monitoring of myeloma during the course of treatment. Bone marrow biopsies provide information about the amount of disease, the type of disease, its aggressiveness, and molecular/genetic abnormalities that help to predict the disease course. They provide the only direct access to tumor cells for examination by a pathologist, so they are necessary even though they are invasive and can be painful. Moreover, because myeloma is patchy and is not distributed evenly throughout the bone marrow, bone marrow biopsies do not always present an accurate sample of what is occurring elsewhere in the marrow.
OTHER TISSUE BIOPSIES
Other tissue biopsies are performed less frequently to determine if myeloma is present outside the bone marrow, or in early stage disease, to biopsy a solitary plasmacytoma.
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step 1: get the correct diagnosis
step 2: tests you really need
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