Multiple myeloma (MM) is a type of cancer. Cancer develops when the cells in the body start to multiply uncontrollably. People with multiple myeloma may undergo frequent blood tests. Doctors might recommend a blood test to help with diagnosis, to check the severity of the cancer, or to see how well treatment is working.

MM affects the plasma cells. Plasma cells are part of the immune system. They make the antibodies the body needs to fight off germs, such as bacteria and viruses.

Plasma cells are located mainly in the bone marrow, which is the soft tissue inside the bones. The body also makes red blood cells and white blood cells in the bone marrow. As the plasma cells multiply, they can crowd out these other cells that the body needs to stay healthy.

MM can also affect other parts of the body, such as the bones and the kidneys.

This article will explain the blood tests people might need and how to prepare for them. It will also explain other types of tests a doctor may recommend.

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Doctors use blood tests in a number of ways when diagnosing MM. Doctors will look for a variety of things in the blood.

Blood cells

As plasma cells multiply controllably, they leave less room for other cells in the bone marrow. This can lead to issues such as:


It is common for a doctor to notice anemia during a blood test for MM.

Anemia is a shortage of red blood cells. Lots of different things can cause anemia, but it can be a sign of MM.

Red blood cells carry oxygen around the body. Symptoms of anemia include weakness and tiredness.


Thrombocytopenia can be a complication of MM that doctors notice during blood tests. It means low levels of platelets in the blood. Platelets help the blood clot properly.

People with thrombocytopenia may bleed or bruise more easily than usual.

Learn more about platelet count blood tests here.


A person with multiple myeloma may also have leukopenia, which can be visible from a full blood count.

Leukopenia means low levels of white blood cells in the blood. White blood cells are an important part of the immune system. Low levels can make it difficult to fight infection.


Another way doctors use blood tests to detect MM is by looking at calcium levels. This is because the disease interrupts the system that builds and maintains bones.

The body makes two types of bone cells to help keep the bones strong and healthy. They are osteoclasts, which break down old bone, and osteoblasts, which make new bone.

According to the American Cancer Society, myeloma cells make a substance that tells the osteoclasts to break down too much bone. As the bones break down too quickly, they release calcium into the blood. This might lead to:

  • bone pain
  • bone weakness
  • fragile bones


When someone has MM, their plasma cells make an abnormal protein that is visible from a blood test. Doctors may call it monoclonal immunoglobulin, monoclonal protein (M-protein), M-spike, or paraprotein.

Having this protein in the blood can be a sign of MM.

Learn about total protein tests here.

Doctors will usually recommend different types of blood tests to people with MM. They tend to order them at the diagnosis stage. They can also help doctors check how well the person’s treatment is working.

Tests include:

Blood counts

A complete blood count (CBC) measures the numbers of:

  • red blood cells
  • white blood cells
  • platelets

Levels of these cells can be low in a person with MM.

Blood chemistry test

During a blood chemistry test, doctors will look at the levels of different chemicals in the blood.

They will measure:

  • Calcium: High levels of calcium may suggest that the MM is affecting the bone.
  • Creatinine: High levels of creatinine may suggest the MM is affecting the kidneys.
  • Albumin: Low levels of albumin can be a sign of MM.

Sometimes, doctors may also suggest measuring lactic dehydrogenase (LDH) levels. High levels can mean that the cancer is more advanced.

Serum protein electrophoresis (SPE)

An SPE test looks for the abnormal protein monoclonal immunoglobulin. Doctors may refer to it as M-protein, M-spike, or paraprotein.

Doctors may also look for the protein in a person’s urine.

Learn what it means to have high levels of protein in the urine here.

People with MM will often have lots of questions. The American Cancer Society encourages them to have frank, open discussions with their cancer care team. This will help them make the best decisions.

Examples of questions to ask at diagnosis include:

  • Where is the cancer located?
  • Has the cancer spread?
  • What other tests do doctors recommend?

Examples of questions to ask when deciding on a treatment plan include:

  • What are my treatment options?
  • What treatment would you recommend and why?
  • what are the potential side effects?

Examples of questions to ask during treatment include:

  • How will I know if treatment is working?
  • How can I manage the side effects?
  • Are there any limitations on activities?

It is also a good idea for people to make a note of any questions they have and take them to their appointment. That way, they will remember to ask them.

Discussing a cancer diagnosis can be a stressful experience.

Learn ways to manage following a cancer diagnosis here.

The most important thing to remember when preparing for a blood test is to follow the healthcare team’s instructions.

Sometimes, the doctor may recommend the person not eat or drink anything ahead of the test.

During a blood test, a healthcare professional will insert a needle into a person’s arm to draw blood into one or more tubes.

The person may feel a slight sting as the needle goes in and comes out. Taking the blood will usually only take around 5 minutes.

Learn more about blood tests here.

MM blood test results will often look complicated. They may show as a set of numbers that doctors call reference ranges.

The National Library of Medicine says these ranges are based on the normal test results of a large group of healthy people. Doctors class results that are outside of this range as “low” or “high/elevated.” Ranges can vary somewhat depending on the laboratory, provider, or facility that processed the test.

People may also see abbreviations on their laboratory report.

Complete blood count

Blood componentAbbreviationReference range
White blood cellsWBC4,500–11,000/millimeters cubed (mm3)
Red blood cellsRBCMale: 4.3–5.9 million/mm3
Female: 3.5–5.5 million/mm3
Plateletsn/a150–400 x 199/L

Blood chemistry

Test targetReference range
CreatinineAge 18–16
Male: 0.9–1.3 milligrams per deciliter (mg/dL)
Female: 0.6–1.1 mg/dL
Age 60–90
Male: 0.8–1.3 mg/dL
Female: 0.6–1.2 mg/dL
Calcium8.6–10.2 mg/dL
Albumin3.5–5.5 grams per deciliter (g/dL)

Learn how long blood test results may take to come through here.

In addition to blood tests, doctors might use a range of tests to detect and monitor MM. They can include:

  • urine tests
  • biopsies
  • imaging tests, such as X-rays and CT scans

Doctors use blood tests to help detect and monitor the cancer multiple myeloma.

Typical blood tests include a CBC, blood chemistry, and SPE. Each of these tests looks for a different sign of MM. To understand the results, it can help to know the normal reference ranges.

Doctors may also use urine tests, biopsies, and imaging tests to look after people with MM.