Diagnosis & Staging


Doctors sometimes find multiple myeloma through routine blood tests or a bone x-ray after people come in for symptoms such as fatigue, weight loss, extreme thirst, infections, pain or broken bones. 

If your symptoms suggest multiple myeloma, you may have one or more of the following tests: 

Blood tests - To check for the number of white blood cells, red blood cells and platelets in the blood. The blood may also be checked for different proteins, including M protein and other antibodies. Tests may also check for high levels of calcium and creatinine levels to see how well the kidneys are working. 

Urine tests - To identify abnormal levels of proteins and antibodies and check kidney function.

X-Ray or Skeletal Survey - To show fractures, breaks or hollowed out areas of bone, which may be caused by multiple myeloma.

Bone marrow biopsy and aspiration – To confirm a multiple myeloma diagnosis, a doctor must remove samples from a person’s bone marrow (aspiration) and a piece of the bone (biopsy) to check for the presence of abnormal plasma cells. A doctor (pathologist) will look at the bone marrow tissue under a microscope to review the appearance, size and shape of the cells, to determine if myeloma cells are present, and if so, how many. The aspirate (liquid) portion of the sample is routinely sent for other tests which will help determine the exact type and genetics of the disease. 


Doctors use tests to help determine how much the cancer has spread and the appropriate treatment options. Knowing all you can about staging lets you take a more active role in making informed decisions about your treatment plan. There are two different types of staging symptoms that a doctor may use to categorize multiple myeloma. 

The traditional system that has been used to stage multiple myeloma is known as the Durie-Salmon staging system. But today, doctors are more commonly using a newer system, called the International Staging System for Multiple Myeloma (ISS). The ISS has three stages, and uses factors such as the levels of proteins found in the blood to help classify each stage. Other important factors that may be important are kidney function, platelet count, and the patient’s age. 

Updated on October 28, 2014