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1 out of 8 patients with multiple myeloma may be missed with SPEP alone1

Cancer care starts with primary care. Reach >99% diagnostic sensitivity by adding sFLC to your multiple myeloma test panel.1

What is multiple myeloma?

Multiple myeloma is the second most common blood cancer in the United States.² Developing from plasma cells in the bone marrow, multiple myeloma often first presents as bone pain, with a study finding that nearly half of myeloma patients experienced such pain, mostly affecting the back, in the two years before diagnosis.³ 

As well as lower back pain, other common symptoms include bruising, fatigue, neuropathy, and recurrent infections.²

Understanding multiple myeloma for healthcare providers

Explore the pathophysiology, staging and prognosis of multiple myeloma to help healthcare providers enhance patient outcomes.

Know the signs of multiple myeloma and populations at greater risk to protect your patients.

While anyone can develop multiple myeloma, individuals at higher risk include those over the age of 65, people with obesity, those with a family history of the disease, and those with a personal history of monoclonal gammopathy of undetermined significance (MGUS).2,4 Multiple myeloma is more common in men and is twice as prevalent among African American and black patients.5

Common clinical abnormalities and signs associated with late-stage multiple myeloma can be remembered with the mnemonic device CRAB,2,6 which stands for:

C

HyperCalcemia

R

Renal insufficiency

A

Anemia

B

Bone lesions

To help diagnose patients earlier, additional criteria were added when the IMWG diagnostic guidelines were updated in 2014. These additions were to help identify myeloma in patients who had not yet suffered the organ damage related to CRAB features. The additional biomarkers can be remembered with the acronym SLiM.

S

Sixty

Patient has ≥60% clonal bone marrow plasma cells in bone marrow biopsy samples

Li

Light chain

Involved/uninvolved serum free Light chain ratio ≥ 100, provided the involved FLC ≥ 100 mg/L

M

MRI

Patient has >1 bone lesion by MRI6

Multiple myeloma detection for healthcare providers

Explore how serum free light chain (sFLC) tests improve sensitivity in multiple myeloma detection, helping healthcare providers diagnose early and save lives.

Non-specific symptoms can cause delayed diagnosis

Of the 24 most common cancers, multiple myeloma has the longest diagnostic delay – the time from initial symptom onset to an official diagnosis.7 This delay in detection can lead to worsening symptoms, organ damage, and even death.

~55 %
of patients present to their PCP first with multiple myeloma symptoms.⁸
30 %
Almost 30% of multiple myeloma patients present in urgent care or emergency settings.⁹
3
Patients have an average of three PCP visits before a hematology referral is ordered.⁹

Multiple guidelines recommend SPEP, IFE, and sFLC

To be compliant with current multiple myeloma guidelines, three serum tests must be used: serum protein electrophoresis (SPEP), Immunofixation electrophoresis (IFE), and serum free light chain (sFLC). Yet only 20% of laboratory orders include sFLC tests.¹⁰

All these professional groups recommend the use of sFLC tests:

  • International Myeloma Working Group (IMWG)6
  • The National Comprehensive Cancer Network (NCCN)11
  • European Myeloma Network12
  • European Hematology Association13
  • European Society for Medical Oncology13
  • UK NICE14
  • College of American Pathologists15

With SPEP alone, 1 in 8 patients with multiple myeloma may go undetected.¹ This can mean that patients will be sent home without answers, and their disease will only progress.

 

By adding sFLC tests to your SPEP and IFE lineup, you can raise diagnostic sensitivity to >99%.¹

Multiple myeloma referral for healthcare providers

Discover best practices for helthcare providers in the referral and follow-up of multiple myeloma to improve patient outcomes.

Early diagnosis of multiple myeloma can save lives

By following the updated guidelines for compliant testing, you can give your patients the best chance of detecting and managing multiple myeloma early.


The use of sFLC alongside SPEP and IFE testing is:

  • Better for patients - early detection improves patient outcomes
  • Better for providers - accurate diagnosis ensures patients aren’t missed
  • Covered by Medicare, Medicaid, and major payors
You are on the front lines of cancer care for your patients. Serve them well by ordering SPEP, IFE, and sFLC tests.
References

  1. Katzmann JA, et al. Screening panels for detection of monoclonal gammopathies. Clin Chem. 2009 Aug;55(8):1517-22
  2. Mikhael et al. Multiple Myeloma for the Primary Care Provider: A Practical Review to Promote Earlier Diagnosis Among Diverse Populations. Am J Med. 2023 Jan;136(1):33-41
  3. Seesaghur A, et al Clinical features and diagnosis of multiple myeloma: a population-based cohort study in primary care. BMJ Open 2021;11:e052759
  4. American Cancer Society: Risk Factors for Multiple Myeloma. Accessed 9/6/2024. https://www.cancer.org/cancer/types/multiple-myeloma/causes-risks-prevention/risk-factors.html
  5. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. seer.cancer.gov. Updated June 8, 2023. Accessed July 14, 2023 https://seer.cancer.gov/statistics-network/explorer/
  6. Rajkumar SV, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014; 15:e538-e548
  7. Shephard EA et al. Quantifying the risk of multiple myeloma from symptoms reported in primary care patients: a large case-control study using electronic records. Br J Gen Pract. 2015
  8. Kariyawasan et al. Multiple myeloma: causes and consequences of delay in diagnosis. QJM. 2007 Oct;100(10):635-40
  9. Hossain MI, et al. An in Depth Analysis of Factors Contributing to Diagnostic Delay in Myeloma: A Retrospective UK Study of Patients Journey from Primary Care to Specialist Secondary Care. Blood. 2021; 138(Supplement 1):3007
  10. Genzen JR et al. Screening and Diagnosis of Monoclonal Gammopathies: An International Survey of Laboratory Practice. Arch Pathol Lab Med 2018; 142: 507-515
  11. NCCN Clinical Practice Guidelines in Oncology® for Multiple Myeloma V.4.2024
  12. Caers J, et al. European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: what to use and when. Haematologica. 2018;103(11):1772-1784
  13. Dimopoulos et al. Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals Onc. 2021; 32: 309-322
  14. Myeloma: diagnosis and management. NICE Guidelines 2016
  15. Keren, D.F., et al., Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies: Guideline From the College of American Pathologists in Collaboration With the American Association for Clinical Chemistry and the American Society for Clinical Pathology. Arch Pathol Lab Med, 2021. 146(5): p. 575-590.