Testing for Prognostic Indicators

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The page below is a sample from the LabCE course Case Studies in Hematology - Malignant WBC Disorders. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Testing for Prognostic Indicators

Much of the further testing determines the patient's prognosis and monitors their progress. Some of the tests included:
  • Beta2-microglobulin (B2M). Lymphocytes and other cells shed this protein. Significantly elevated levels are a poor prognostic indicator and indicate extensive disease.
  • Lactate Dehydrogenase (LDH). This non-specific enzyme results from cell destruction and turnover; higher levels also indicate more disease involvement and poorer prognosis.
  • Fluorescence In Situ Hybridization (FISH). This cytogenetic test detects chromosomal abnormalities such as trisomies, translocations, and other abnormalities. Those changes indicating higher risk and poorer prognosis include translocations t(14;16) and t(14;20); and loss of p53 gene locus (del17p).
  • Tests for kidney function such as creatinine.
  • Imaging studies to detect bone lesions commonly result from infiltration of the myeloma cells.