Patients' Guide to Spinal Cancer

How Multiple Myeloma of the Spine Is Diagnosed

Tests that help determine if you have this type of blood cancer that affects the spine

Multiple myeloma is a blood cancer that can weaken and damage the bones of your spine. This cancer originates in the plasma cells that live in your bone marrow. During your diagnostic evaluation, your doctor will review your medical history, symptoms, and perform a physical and neurological examination. The doctor’s findings are combined with results from lab tests and imaging studies to make an accurate diagnosis.

Multiple Myeloma: A Multi-faceted Diagnostic Approach

Multiple myeloma is challenging to diagnose and stage based on one lab test, so doctors typically perform several tests to confirm a diagnosis. The first line of diagnostic testing usually includes blood and urine tests, and a bone marrow biopsy. After that, imaging tests such as x-rays, MRIs, and CT scans may be performed.
Composition of bone marrow cells (labeled)The first line of diagnostic testing usually includes blood and urine tests, and a bone marrow biopsy. Photo Source:

Blood and urine tests

Blood and urine tests will detect M proteins, which are produced by myeloma cells. Blood tests can also identify problems related to kidney function, calcium levels (hypercalcemia is a common symptom of multiple myeloma), and red blood cell count to detect possible anemia.

Bone marrow aspiration and biopsy

Two other diagnostic steps are bone marrow aspiration and biopsy. Bone marrow is comprised of both solid and liquid components, and these tests measure each of them. A bone marrow aspiration uses a needle to extract some of the bone marrow liquid, while a bone marrow biopsy uses a different type of needle to remove a small portion of the solid marrow. These samples are typically taken from marrow in the pelvic bone.

Imaging scans

X-rays, magnetic resonance imaging (MRI), and CT scans are types of imaging tests performed to help detect, identify and define area/s of bone damage and tumor (eg, plasmacytoma, a plasma cell tumor). Although x-rays provide your doctor basic but important information, an MRI or CT scan can provide significant structural detail in different visual formats (eg, front, back, side, overhead).
Spine cancer: plasmacytoma cord compression Spine cancer: plasmacytoma cord compression

Multiple Myeloma Diagnostic Criteria

Doctors follow specific multiple myeloma diagnostic criteria to confirm the disease. For multiple myeloma to be diagnosed, a doctor must confirm one major and one minor criteria, or three minor criteria, in a patient with who is experiencing symptoms of the disease.

Major criteria include:

  • Confirmation of plasmacytoma from a biopsy
  • 30 percent plasma cells in a bone marrow sample
  • High levels of M protein in the blood or urine

Minor criteria include:

  • 10 percent to 30 percent plasma cells in a bone marrow sample
  • Slight increases in M protein levels in the blood or urine
  • Bone soft spots, known as osteolytic lesions, which can show up in imaging studies
  • Low levels of antibodies in the blood

You’ve Been Diagnosed with Multiple Myeloma—Now What?

If you’ve been diagnosed with multiple myeloma, the next step is to meet with a hematologist/oncologist who has experience treating multiple myeloma. The specialist will help you understand multiple myeloma. Furthermore, a personalized treatment plan is developed that includes helping you to manage pain and other symptoms.

Updated on: 08/06/19
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Symptoms of Multiple Myeloma in the Spine

Multiple myeloma is a complex disease with no known cause. This blood cancer affects each person differently—some people have a variety of symptoms, while others experience none.
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