American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which tools are useful in determining the prognosis of multiple myeloma requiring therapy?

Complete blood count and serum creatinine levels
β2-microglobulin and lactate dehydrogenase
M protein and serum calcium
Bone imaging and kidney function tests

The correct answer is: β2-microglobulin and lactate dehydrogenase

The determination of prognosis in multiple myeloma that requires therapy relies heavily on specific serum markers that reflect disease burden and biological activity. β2-microglobulin and lactate dehydrogenase (LDH) are particularly significant in this context. β2-microglobulin is a protein that is often elevated in patients with multiple myeloma and serves as an important prognostic marker. Elevated levels indicate a higher tumor burden and are associated with inferior survival and a more aggressive disease course. Lactate dehydrogenase, on the other hand, is an enzyme that, when elevated, suggests increased cellular turnover or tissue damage. In multiple myeloma, high LDH levels have been linked to advanced disease and poorer prognosis, indicating a more aggressive form of the illness. Together, these markers provide a clearer picture of the disease's aggressiveness and potential outcomes, making them essential tools for clinicians when assessing prognosis in patients with multiple myeloma requiring therapy. These parameters are well established in the International Staging System for multiple myeloma, highlighting their critical role in clinical practice.