The Diagnosis and Investigation of Multiple Myeloma in 2018

Abstract:

Background and objectives: Multiple myeloma is a complex neoplastic plasma cell disorder which necessitates a high index of suspicion and a rational approach to diagnosis. The diagnosis requires meeting specific criteria, which were revised in 2014 by the International Myeloma Working Group to enable earlier diagnosis and initiation of treatment. The aim of this article is to update medical and laboratory professionals in the approach to the diagnosis and investigation of multiple myeloma, as it is currently defined.

Method: A systematic review was conducted of the latest literature published on multiple myeloma, its diagnosis and investigation and its associated complications.

Results: A streamlined and step-wise approach to the investigation and diagnosis of multiple myeloma is proposed starting with initial screening tests, followed by diagnostic investigations and tests to rule out complications of multiple myeloma, and lastly investigations for staging and prognostication.

Conclusion: This approach will hopefully improve and standardise the current work-up of patients with multiple myeloma by detecting disease and complications earlier and avoiding inappropriate referrals and costly repeated or unnecessary investigations.