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Test Code MSMRD Myeloma Stratification and Risk-Adapted Therapy with Reflex to Minimal Residual Disease, Bone Marrow


Ordering Guidance


This test should be ordered on patients treated for multiple myeloma to confirm remission has been achieved, as an annual follow-up of those in remission or in uncertain remission, or when MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow is desired.

 



Necessary Information


1. Include patient's disease state (untreated, treated, monoclonal gammopathy of undetermined significance, stable).

2. Indicate if patient is on anti-CD38 therapy.



Specimen Required


Specimen Type: Redirected bone marrow

Preferred: Yellow top (ACD solution A or B)

Acceptable: Lavender top (EDTA)

Specimen Volume: 4 mL


Useful For

Risk stratification of patients with treated multiple myeloma, which can assist in determining treatment and management decisions

 

Risk stratification of patients with newly diagnosed multiple myeloma

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
CSMRT MPCDS Pre-Analysis Cell Sorting, BM No No
MPCDS mSMART Eval, PCPDs, FISH Yes, (Order PCPDS) No
MRDMR Multiple Myeloma MRD by Flow, BM Yes, (Order MRDMM) No

Method Name

Flow Cytometry/DNA Content/Cell Cycle Analysis

Reporting Name

mSMART with Reflex to MRD, BM

Specimen Type

Bone Marrow

Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Bone Marrow Ambient (preferred) 72 hours
  Refrigerated  72 hours

Reject Due To

Gross hemolysis Reject
Fully clotted Reject

Clinical Information

Multiple myeloma is increasingly recognized as a disease characterized by marked cytogenetic, molecular, and proliferative heterogeneity. This heterogeneity is manifested clinically by varying degrees of disease aggressiveness. Multiple myeloma patients with more aggressive disease experience suboptimal responses to some therapeutic approaches; therefore, identifying these patients is critically important for selecting appropriate treatment options.

 

The Mayo algorithmic approach for stratification of myeloma and risk-adapted therapy classifies patients into either standard or high-risk categories based on the results of 2 assays: plasma cell proliferation and fluorescence in situ hybridization for specific multiple myeloma-associated abnormalities.

Reference Values

PLASMA CELL CLONALITY:

Normal bone marrow

No monotypic clonal plasma cells detected

 

DNA INDEX:

Normal polytypic plasma cells

DNA index (G0/G1 cells): Diploid 0.95-1.05

Day(s) Performed

Preanaltyical processing: Monday through Saturday

Results reported: Monday through Friday

Report Available

1 to 13 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

88182-Flow cytometry, cell cycle or DNA analysis

88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker

88185 x 5-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each)

88187-Flow cytometry interpretation, 2 to 8 Markers