Initial screening test for suspected multiple myeloma is which?

Initial screening test for suspected multiple myeloma is which?

• A. Serum protein electrophoresis
• B. Bone marrow biopsy
• C. Urine protein electrophoresis
• D. CBC

Answer: (A)

Detecting a monoclonal protein in the blood is the first step when multiple myeloma is suspected. Serum protein electrophoresis reveals a sharp, discrete band called an M-protein that comes from a single clone of malignant plasma cells. That monoclonal spike is the clue that prompts confirmation tests, so this is the best initial screen. If an M-spike is found, further workup with immunofixation to identify the specific type of immunoglobulin, and other studies to confirm diagnosis and assess extent, follow. Urine protein electrophoresis can detect light chains (Bence Jones proteins) but it isn’t the primary screening test. A complete blood count may show anemia or other nonspecific changes but doesn’t establish monoclonality.

Detecting a monoclonal protein in the blood is the first step when multiple myeloma is suspected. Serum protein electrophoresis reveals a sharp, discrete band called an M-protein that comes from a single clone of malignant plasma cells. That monoclonal spike is the clue that prompts confirmation tests, so this is the best initial screen. If an M-spike is found, further workup with immunofixation to identify the specific type of immunoglobulin, and other studies to confirm diagnosis and assess extent, follow. Urine protein electrophoresis can detect light chains (Bence Jones proteins) but it isn’t the primary screening test. A complete blood count may show anemia or other nonspecific changes but doesn’t establish monoclonality.