Patient evaluation.
| Diagnostic evaluation |
| Presence and characterization of monoclonal protein |
| Serum protein electrophoresis and quantitative immunoglobulin |
| 24-hour urine: total protein & Bence Jones protein |
| Immunofixation of urine and serum |
| Serum free light chain and ratio |
| Bone marrow aspirate and biopsy |
| Histology |
| Immunophenotyping – clonality |
| End organ damage evaluation |
| CBC with differential |
| Chemistry panel: serum creatinine and calcium |
| Skeletal survey |
| Prognostic evaluation |
| Albumin |
| β2 microglobulin |
| LDH |
| C-reactive protein |
| Bone marrow cytogenetics and FISH |
| Specialized studies for selected patients |
| Abdominal fat pad or rectal biopsy for amyloid |
| Solitary lytic lesion biopsy |
| Serum viscosity if IgM or high IgA levels or serum M-component > 7 g/dL |
| Immunofixation for IgD or IgE in select cases |
| MRI with STIR images in oligosecretory disease |
| Diagnostic evaluation |
| Presence and characterization of monoclonal protein |
| Serum protein electrophoresis and quantitative immunoglobulin |
| 24-hour urine: total protein & Bence Jones protein |
| Immunofixation of urine and serum |
| Serum free light chain and ratio |
| Bone marrow aspirate and biopsy |
| Histology |
| Immunophenotyping – clonality |
| End organ damage evaluation |
| CBC with differential |
| Chemistry panel: serum creatinine and calcium |
| Skeletal survey |
| Prognostic evaluation |
| Albumin |
| β2 microglobulin |
| LDH |
| C-reactive protein |
| Bone marrow cytogenetics and FISH |
| Specialized studies for selected patients |
| Abdominal fat pad or rectal biopsy for amyloid |
| Solitary lytic lesion biopsy |
| Serum viscosity if IgM or high IgA levels or serum M-component > 7 g/dL |
| Immunofixation for IgD or IgE in select cases |
| MRI with STIR images in oligosecretory disease |