Osteosclerotic Myeloma

Supplemental Studies

Clonal plasma cells can be demonstrated by flow, immunohistology or in situ hybridization
- Usually lambda light chain
- Bone marrow plasmacytosis usually <5-10%, if present

Serum or urine protein electrophoresis, immunofixation, light chain quantification
- Serum M protein usually <3.5 g/dL, if present
- Bence Jones protein usually <1 g/24hr, if present
Quantitation and typing of monoclonal immunoglobulin / light chain
- Usually IgA or IgG lambda
Serum free light chain analysis may be required to demonstrate clonal light chains
These studies may be used to
- Establish presence of a monoclonal plasma cell population
- Quantitation helps subtype the plasma cell dyscrasia (i.e. >3g/dL serum monoclonal protein is a major criterion for myeloma)
- Track disease burden over time
Serum VEGF often markedly elevated