Key Benefits

• Screen for abnormal blood proteins linked to multiple myeloma and related disorders.
• Spot high total protein or globulin that raises concern for monoclonal proteins.
• Flag a low A/G ratio that suggests excess globulins from plasma cells.
• Explain albumin’s role in staging and prognosis alongside beta-2 microglobulin.
• Use ESR to flag inflammation or high immunoglobulins that accelerate red cell settling.
• Clarify unexplained fatigue, bone pain, or infections by matching symptoms with protein patterns.
• Track treatment response as albumin rises and globulin or ESR gradually normalize.
• Best interpreted with SPEP, free light chains, and your clinical picture.

What are Multiple Myeloma

Biomarker testing in multiple myeloma captures what the cancerous plasma cells are making and how their activity affects the body, enabling diagnosis, risk stratification, treatment selection, and precise monitoring over time. The most direct signals are the abnormal antibody proteins the tumor secretes into blood and urine—whole antibodies or fragments that serve as a chemical “signature” of the clone (monoclonal protein/M‑protein and free light chains, kappa/lambda). Their presence and change over time reflect disease activity. Other biomarkers report on the tumor’s biology and its stress on organs: a small cell-surface protein shed by many cells (beta‑2 microglobulin) relates to tumor burden and kidney handling; an enzyme released with rapid cell turnover (lactate dehydrogenase, LDH) reflects aggressiveness; a major blood protein (albumin) mirrors the body’s inflammatory environment. Genetic changes inside myeloma cells (cytogenetic abnormalities by FISH) act as risk biomarkers that inform prognosis and therapy choices. After treatment, highly sensitive tests for tiny amounts of remaining disease (minimal residual disease, MRD, by flow cytometry or sequencing) indicate the depth and durability of response.

Why are Multiple Myeloma biomarkers important?

Multiple myeloma biomarkers track how abnormal plasma cells reshape the body’s protein economy, inflammation, and organ performance. Because myeloma secretes monoclonal immunoglobulins and disrupts normal antibody and albumin production, these markers reflect not just blood chemistry but bone marrow function, blood “thickness,” kidney stress, and immune defense.

Typical reference ranges: albumin 3.5–5.0 with optimal in the mid–high range; total protein 6.0–8.3 with optimal mid-range; globulin 2.0–3.5 with optimal moderate; A/G ratio 1.0–2.2 with optimal above 1 (often ~1.5–2); ESR generally lowest in men under 15 and women under 20, trending higher with age, with optimal toward the low end. In pregnancy, albumin trends lower and ESR higher from hemodilution; children have lower ESR.

When values are low, they signal different physiologic stresses. Low albumin reflects inflammation or kidney loss of protein from light chains; in myeloma it often tracks disease activity and correlates with fatigue, swelling, and poor appetite. Low total protein suggests malnutrition, liver disease, or heavy urinary protein loss; in some myeloma cases, light-chain leakage can keep total protein deceptively normal or low. Low globulin indicates immunoparesis—suppressed normal antibodies—leading to recurrent sinus and chest infections. A low A/G ratio usually means albumin has fallen or globulins have risen; in myeloma, it commonly reflects globulin excess. A very low ESR is generally not concerning and does not rule out myeloma.

High globulin and total protein point to monoclonal protein excess, raising blood viscosity and contributing to headaches, blurred vision, bleeding, and neuropathy; ESR often becomes markedly elevated from rouleaux. Together, these biomarkers connect the plasma-cell clone to marrow anemia, bone loss, kidney injury, and infection risk, helping gauge burden, complications, and long-term outcomes such as fractures, renal failure, and cardiovascular strain from hyperviscosity.

What Insights Will I Get?

Multiple myeloma alters the body’s protein economy, reshaping immunity, blood viscosity, kidney load, and energy delivery to tissues. Tracking protein-based biomarkers shows how plasma cells are affecting systems that keep fluids balanced, oxygen moving, and organs perfused. At Superpower, we test these specific biomarkers: Albumin, Total Protein, Globulin, A/G ratio, ESR.

Albumin is the liver’s main carrier protein and the chief contributor to oncotic pressure; it often falls in myeloma due to inflammation or renal loss. Total Protein reflects the sum of albumin and globulins and rises when a monoclonal immunoglobulin (“M protein”) is present. Globulin captures immunoglobulins and other binding proteins and typically increases with myeloma. The A/G ratio expresses the balance between albumin and globulin; a low ratio suggests globulin excess or albumin deficit, both common in myeloma. ESR (erythrocyte sedimentation rate) rises when high protein levels promote rouleaux formation; it is frequently elevated in myeloma.

Together, higher Total Protein and Globulin with a low A/G ratio indicate excess immunoglobulin load that can thicken blood, strain kidneys, and blunt microcirculatory flow. Lower Albumin signals reduced synthetic reserve or heightened inflammatory burden and aligns with disease severity. A markedly elevated ESR reflects systemic protein excess and inflammatory activity. In combination, these markers help gauge disease activity, organ stress, and physiologic stability over time.

Notes: Interpretation is influenced by age, pregnancy (lower albumin, higher ESR), acute or chronic infections, liver or kidney disease, dehydration (concentrates proteins), and anti-inflammatory or steroid medications (can lower ESR). Assay methods and timing of sampling also affect results.