Proper Diagnosis and Risk Stratification to Guide Treatment
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Diagnosis of Multiple Myeloma
The diagnosis of multiple myeloma is established by integrating the pertinent clinical, laboratory, radiologic, and pathologic data. The enumeration of plasma cells in an adequate bone marrow specimen and establishment of plasma cell clonality are the key components of this evaluation.
Clonality is inferred by showing monotypic immunoglobulin light chain expression (kappa or lambda) in the plasma cells. Rarely, no detectable immunoglobulin is identified. Flow cytometric immunophenotyping, immunohistochemistry, and in situ hybridization are the commonly used methods for establishing plasma cell clonality.