Multiple Myeloma Precision Diagnosis
At Fosun Health, multiple myeloma diagnosis is not just about “finding cancer cells”—it is about quantifying the monoclonal protein, determining the cytogenetic risk group, and identifying targetable mutations to design a personalized plan that controls the disease for years while preserving your quality of life. Our streamlined pathway delivers answers within days:
- Serum Protein Electrophoresis (SPEP) & Immunofixation: Detects and identifies the monoclonal (M) protein (IgG, IgA, IgM, or light chains).
- Serum Free Light Chain (FLC) Assay: Measures kappa and lambda light chains; an abnormal ratio indicates clonal plasma cell proliferation.
- Quantitative Immunoglobulins: Measures levels of normal antibodies (IgG, IgA, IgM) which are often suppressed.
- Complete Blood Count (CBC): Detects anemia, leukopenia, thrombocytopenia.
- Creatinine, Calcium, Albumin, LDH: Assesses kidney function, hypercalcemia, and tumor burden.
- 24 Hour Urine Protein: Quantifies Bence Jones protein (free light chains) and measures kidney damage.
The gold standard. Under local anesthesia, we obtain a bone marrow sample from the hipbone. We examine:
- Plasma cell percentage (≥10% is diagnostic; ≥60% defines high-risk).
- Plasma cell morphology (mature, immature, or plasmablastic).
- Immunohistochemistry for CD138, CD38, CD56 (plasma cell markers).
- Flow cytometry to detect clonal plasma cells (CD38+/CD138+ with light chain restriction).
- Low-Dose Whole-Body CT: Detects lytic bone lesions (punched out lesions), osteopenia, and fractures.
- PET-CT: More sensitive for detecting small or metabolically active bone lesions and extramedullary disease (plasmacytomas outside bone).
- Whole-Body MRI: Preferred for detecting bone marrow infiltration without radiation; especially useful for spine assessment.
Risk stratification is critical. We perform FISH on purified plasma cells to detect:
- High risk abnormalities: del(17p), t(4;14), t(14;16), t(14;20), gain(1q), del(1p).
- Standard risk: hyperdiploidy, t(11;14), t(6;14).
- Other: RAS/RAF mutations, TP53 mutations, MYC rearrangements.
Using bone marrow samples, we analyze KRAS/NRAS, BRAF, TP53, DIS3, FAM46C, IRF4, CCND1, and over 300 myeloma related genes. This determines whether your myeloma will respond to BRAF inhibitors (vemurafenib, dabrafenib) for BRAF mutated disease, BCL 2 inhibitor (venetoclax) for t(11;14) positive myeloma, RAS pathway inhibitors (clinical trials), or XPO1 inhibitor (selinexor) . It also identifies resistance mechanisms and guides treatment sequencing.
