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- • Complete blood count (CBC) each week after the initial treatment, to follow the effect on hemoglobin , white
- blood cells and platelets. After the appropriate dose of chemotherapy and the time required for recovery have
- been determined, a CBC will be required only before the next course of chemotherapy. Most patients can take
- repeat courses of melphalan and prednisone every four weeks, but recovery may be delayed in some, who will
- have to wait six weeks between courses.
- • Serum calcium and creatinine every 6 to 12 weeks.
- • If the patient is excreting light-chain protein in the urine (Bence Jones protein), the total protein excreted in a
- 24-hour urine specimen should be measured before every course of treatment, to determine if the treatment is
- reducing the production of Bence Jones protein by the myeloma cells. Electrophoresis of the urine protein
- should be done occasionally, especially if the amount increases or does not disappear, to make sure that
- mainly light chains are being excreted. Some patients will develop a nephrotic syndrome and excrete a mixture
- of serum proteins.
- • Bone x-rays should be taken to investigate the causes of new bone pain.
- • Repeat bone marrow examination may be needed to confirm remission or relapse.
