Ask the Nurse: Blood tests in myeloma

Blood tests are one of the commonly used tests and investigations for diagnosing and monitoring myeloma. Going for your blood test, waiting for your results and trying to make sense of them can be a worrying or confusing time. But it’s important to remember that blood tests help your healthcare team to understand how myeloma is affecting you and in planning the right treatments at the right time.

In this month’s blog, we answer some of the questions you ask our Myeloma Infoline to help you understand more about your blood tests.

What is a blood test?

Blood tests may be carried out at your GP surgery or in a hospital. They are often used to check your general health. They are an important part of diagnosing and monitoring myeloma and related conditions.

A needle is inserted into your vein, usually in your arm, to draw out a sample of blood. This is analysed in a laboratory. Different components of the blood are compared to expected values. You can read more in our Tests and investigations in myeloma Infoguide.

How should I prepare for a blood test?

There is no preparation needed. You can eat and drink normally before most blood tests, unless you have been told otherwise by your healthcare team. If you feel nervous before a blood test, let the healthcare staff know – they can talk you through what to expect and support you. Relaxation techniques such as taking deep breaths may also help. If you are worried about feeling faint after your blood has been taken, you might like to take a snack to eat after the test.

How often will I have blood tests?

Blood tests are used as part of the diagnostic tests for myeloma. If you are diagnosed with myeloma, you will also have regular blood tests to help monitor your condition.

If you are having treatment, regular blood tests are done to look at how you are responding to treatment and monitor any side effects you may be having.

When you are in remission or plateau, you are also monitored with regular blood tests. Waiting for test results can be a stressful time and you may feel anxious but remember that the tests mean your healthcare team are taking care of you by keeping a close eye on things.

It may help to talk to your friends and family or your healthcare team. Our Myeloma Information Specialists can also offer support – get in touch on 0800 980 3332 (UK) or 1800 937 773 (Ireland), or use our Ask the Nurse email service.

Which blood tests will I have?

There are several blood tests that give vital information about how your body is functioning. The different tests might feel confusing, but they help to give your healthcare team a good understanding of your overall health, identify any issues and provide the right treatments or preventative measures. Maintaining your health and wellbeing is the priority.

Full blood count (FBC)

A full blood count (FBC) measures the numbers of different cells in your blood.   Checking the different types of cells can help your healthcare team to understand more about your general health:

• Red blood cells (RBC) containing haemoglobin carry oxygen around the body. A low RBC count or haemoglobin level can indicate anaemia, a common side effect of myeloma. This can make you feel tired, short of breath and dizzy.
• White blood cells (WBC) are immune cells. There are different types of WBC that defend our body against infection, such as neutrophils and lymphocytes. Low counts of some or all the different WBCs can mean that you are at a greater risk of infection.
• Platelets help blood to clot. A low platelet count means you have an increased risk of bleeding or bruising.

Paraprotein tests

Paraprotein is the abnormal protein produced by some myeloma cells.  The level of paraprotein can be used to help diagnose and monitor myeloma. As these tests are one of the key indicators for diagnosing and monitoring myeloma, it is understandable for some people to worry about the results. However, these tests are an important way for your healthcare team to understand your myeloma and provide the right treatment and care at the right time.

• Serum protein electrophoresis detects the presence and amount of different proteins in the blood. It can separate all the proteins by size and show if there is a large amount of one particular protein in the blood, such as paraprotein.
• Immunofixation electrophoresis can give more information about the type of paraprotein.
• The serum free light chain assay helps detect small proteins called light chains in your blood. If you have light chains in your blood but no paraprotein, you may have a type of myeloma called light chain myeloma. Read more in our Paraproteins and free light chains blog.

Blood chemistry

Blood chemistry tests measure the different chemicals present in our blood as these levels can change in different health conditions such as myeloma and from side effects of treatments.

An abnormal result can indicate a need for further tests, new treatments or a change to your treatment.

More details about the tests carried out can be found in our Tests and investigations in myeloma Infoguide.

How can I understand my results?

Blood test results can be difficult to read and understand. Your healthcare team (haematologist and/or clinical nurse specialist) will monitor your blood test results and can explain what they mean. Don’t be afraid to ask them questions to help you understand your results and what they mean for you. It can be helpful to write any questions or notes down ahead of your appointment, so you feel prepared.  

Our Tests and investigations in myeloma Infoguide, pages 53-54, highlights the normal ranges for blood tests. This might help you to understand your own results. Because blood test results can fluctuate up and down somewhat, usually your healthcare team will focus on what happens to blood tests over time, so try not to worry too much over individual results. You may find it useful to keep a note of your blood test results so that you can refer to your own ranges. Our patient diary has a dedicated space for recording test results, you can download or order a copy online.

If you have any further questions or need support, contact us through the Myeloma UK Infoline at 0800 980 3332 (UK) or 1800 937 773 (Ireland) or use our Ask the Nurse email service.