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Multiple Myeloma: Sensitivity and Specificity

Introduction: Multiple myeloma is a plasma cell neoplasm producing a large amount of an immunoglobulin (IgG) causing end-organ damage. In particular, the patient must meet the following 3 criteria:

  • Presence of a monoclonal protein in the serum and/or urine
  • Presence of monoclonal plasma cells in the bone marrow >10%
  • Presence of end-organ damage: hypercalcemia, renal insufficiency, anemia, or lytic bone lesions
  • Diagnosis of a monoclonal proteinopathy proceeds with SPEP, UPEP, free light chains (FLC).

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    Tags: Hematologic Neoplasm Tag this Diagnosis.

    The sensitivity and specificity of findings for Multiple Myeloma are listed below. See the left navigation bar to change the display.

    Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
    **Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
    Sensitive and Specific Findings
    FindingResult SensitivitySpecificity
    [ + ] SPEP and FLC + 0 - 100%99%
    [ + ] Serum Free Light Chains + 0 - 88%98%
    Sensitive Findings
    FindingResult SensitivitySpecificity
    [ + ] Serum Immunofixation Electrophoresis Sensitivity = 93%
    [ + ] Proteinuria Sensitivity = 88%
    Poorly Diagnostic Findings
    FindingResult SensitivitySpecificity
    [ + ] SPEP + 0 - 64%81%
    [ + ] X-Ray Sensitivity = 79%
    [ + ] UPEP Sensitivity = 75%
    [ + ] Renal Insufficiency Sensitivity = 55%
    [ + ] Bence-Jones Proteinuria Sensitivity = 49%
    [ + ] Hypercalcemia Sensitivity = 30%
    [ + ] Palpable Liver Sensitivity = 21%
    [ + ] Hypogammaglobulinemia Sensitivity = 9%
    [ + ] Palpable Spleen Sensitivity = 5%