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Test Code MSMRT Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow

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

Method Name

Flow Cytometry/DNA Content/Cell Cycle Analysis

Reporting Name

mSMART Algorithmic Testing, BM

Specimen Type

Bone Marrow


Ordering Guidance


This test should be ordered at diagnosis or for a known relapsing patient of multiple myeloma.

 

For follow-up of a plasma cell neoplasm (plasma cell proliferative disorder), order MSMRD / Myeloma Stratification and Risk-Adapted Therapy with Reflex to Measurable/Minimal Residual Disease, Bone Marrow.



Necessary Information


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



Specimen Required


Specimen Type: Redirected bone marrow

Preferred: Yellow top (ACD solution A or B

Acceptable: Lavender top (EDTA) or green top (heparin)

Specimen Volume: 4 mL


Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time
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

Monday through Saturday

Report Available

1 to 11 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

Forms

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.