Multiple Myeloma & Plasma Cell Disorders

Causes & Risk Factors

Multiple myeloma risk factors are less well-defined than for some other cancers, but several associations are recognized:

•  Age — risk increases significantly with age; the disease is uncommon before age 40.

•  Sex — slightly more common in men than women.

•  Family history — having a first-degree relative with multiple myeloma modestly increases risk.

•  MGUS (Monoclonal Gammopathy of Undetermined Significance) — a precursor condition that carries a small annual risk of progressing to multiple myeloma, requiring periodic monitoring.

•  Obesity — associated with modestly increased risk based on epidemiological data.

Symptoms & When to Test

Multiple myeloma symptoms are often remembered by the acronym "CRAB" — calcium elevation, renal (kidney) impairment, anemia, and bone disease — though presentation varies between patients.

•  Bone pain, particularly in the back, hips, or ribs — often the most common presenting symptom

•  Persistent fatigue, often related to anemia

•  Recurrent infections, due to impaired normal antibody production

•  Symptoms of kidney impairment, such as reduced urine output or swelling

•  Symptoms of elevated calcium, including excessive thirst, nausea, constipation, or confusion

•  Unexplained bone fractures

When Should You Consider Testing?

Unexplained persistent bone pain, unexplained anemia, recurrent infections, or new kidney impairment — particularly occurring together — warrant evaluation for a possible plasma cell disorder, typically beginning with blood and urine protein studies.

Why Tests Are Combined

No single test establishes the full picture of multiple myeloma — SPEP and IFE detect and characterize the abnormal monoclonal protein, serum free light chains provide a highly sensitive complementary measure (particularly useful in light-chain-only disease), and quantitative immunoglobulins show the degree to which normal antibody production is suppressed.

Beta-2 microglobulin, CBC, and calcium/renal function tests assess disease burden and organ involvement, which are essential for staging and determining urgency of treatment, while bone marrow examination confirms the diagnosis and quantifies plasma cell involvement directly.

Cytogenetic and molecular investigations, where performed, add prognostic information — since specific chromosomal abnormalities in myeloma cells are associated with different risk categories that can influence treatment intensity and monitoring frequency.

Tests Available at NPL

Most tumor molecular tests, histopathology, IHC, and genetic tests do not require fasting. However, some blood-based investigations ordered alongside cancer testing may have specific preparation requirements. Please follow the instructions provided by your doctor or NPL.

Home Sample Collection

Most multiple myeloma blood tests (SPEP, IFE, free light chains, quantitative immunoglobulins, beta-2 microglobulin, CBC, calcium, renal function) can be arranged through NPL's standard home sample collection service.

Bone marrow examination, required to confirm diagnosis and assess marrow plasma cell involvement, must be performed by a hematologist at a hospital or clinic — this is not a home collection service.

Once your bone marrow sample is obtained, NPL arranges secure transport to our accredited laboratory for analysis, including cytogenetic and molecular testing where indicated.

Ongoing monitoring blood tests during treatment can typically be arranged via home collection — confirm with your treating hematologist.

When to See a Doctor

•  Persistent, unexplained bone pain, particularly in the back, hips, or ribs

•  Unexplained fatigue or anemia

•  Recurrent infections

•  New or worsening kidney impairment

•  Symptoms suggestive of elevated calcium (excessive thirst, confusion, constipation)

•  Known MGUS with new symptoms — requires prompt reassessment