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HelpTest Code CSMRT mSMART Plasma Cell Proliferative Disorder, Pre-Analysis Cell Sorting, Bone Marrow
Specimen Required
Only orderable as a reflex. For more information see MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow or MSMRD / Myeloma Stratification and Risk-Adapted Therapy with Reflex to Minimal Residual Disease, Bone Marrow
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
Secondary ID
607626Useful For
Risk stratification of patients with multiple myeloma, which can assist in determining treatment and management decisions
Sorting plasma cells for fluorescence in situ hybridization analysis
Risk stratification of patients with newly diagnosed multiple myeloma
Method Name
Only orderable as a reflex. For more information see MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow or MSMRD / Myeloma Stratification and Risk-Adapted Therapy with Reflex to Minimal Residual Disease, Bone Marrow
Flow Cytometric Cell Selection
Reporting Name
MPCDS Pre-Analysis Cell Sorting, BMSpecimen Type
Bone MarrowSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Bone Marrow | Ambient (preferred) | 4 days | |
| Refrigerated | 4 days |
Reject Due To
| Gross hemolysis | Reject |
| Other | Fully clotted |
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.
MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow classifies patients into either standard or high-risk categories based on the results of 2 assays: plasma cell proliferation and FISH for specific multiple myeloma-associated abnormalities.
Reference Values
Only orderable as a reflex. For more information see MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow or MSMRD / Myeloma Stratification and Risk-Adapted Therapy with Reflex to Minimal Residual Disease, Bone Marrow
An interpretive report will be provided.
Interpretation
Correlation with clinical, histopathologic and additional laboratory findings is required for final interpretation of these results. The final interpretation of results for clinical management of the patient is the responsibility of the managing physician.
Cautions
No significant cautionary statements
Clinical Reference
1. Rajkumar SV, Greipp PR. Prognostic factors in multiple myeloma. Hematol Oncol Clin North Am. 1999;13(6):1295-1314
2. Garcia-Sanz R, Gonzalez-Fraile MI, Mateo G, et al. Proliferative activity of plasma cells is the most relevant prognostic factor in elderly multiple myeloma patients. Int J Cancer. 2004;112(5):884-889
3. Orfao A, Garcia-Sanz R, Lopez-Berges MC, et al. A new method for the analysis of plasma cell DNA content in multiple myeloma samples using a CD38/propidium iodide double staining technique. Cytometry. 1994;17(4):332-339
4. Morice WG, Hanson CA, Kumar S, et al. Novel multi-parameter flow cytometry sensitively detects phenotypically distinct plasma cell subsets in plasma cell proliferative disorders. Leukemia. 2007;21(9):2043-2046
5. Gonsalves WI, Buadi FK, Ailawadhi S, et al. Utilization of hematopoietic stem cell transplantation for the treatment of multiple myeloma: a Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus statement. Bone Marrow Transplant. 2019;54(3):353–367. doi:10.1038/s41409-018-0264-8
6. Kapoor P, Ansell SM, Fonseca R, et al. Diagnosis and management of waldenstrom macroglobulinemia: Mayo stratification of macroglobulinemia and risk-adapted therapy (mSMART) guidelines 2016. JAMA Oncol. 2017;3(9):1257–1265. doi:10.1001/jamaoncol.2016.5763
7. Mikhael JR, Dingli D, Roy V, et al. Management of newly diagnosed symptomatic multiple myeloma: updated Mayo stratification of myeloma and risk-adapted therapy (mSMART) consensus guidelines 2013. Mayo Clin Proc. 2013;88(4):360–376. doi:10.1016/j.mayocp.2013.01.019
8. Swerdlow S, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press: Lyon. 2017
9. Kumar SK, Rajkumar SV. The multiple myelomas-current concepts in cytogenetic classification and therapy. Nat Rev Clin Oncol. 2018;15(7):409-421. doi:10.1038/s41571-018-0018-y
10. Rajkumar SV, Landgren O, Mateos MV. Smoldering multiple myeloma. Blood. 2015;125(20):3069-3075. doi:10.1182/blood-2014-09-568899
Method Description
Selection of plasma cells using fluorescence activated cell sorting is the most direct and robust method of obtaining relatively pure plasma cell populations for fluorescence in situ hybridization (FISH) assessment.(Instruction manual: BD FACSMelody Cell Sorter User's Guide. Revision 3. BD Biosciences; 03/2020)
Day(s) Performed
Specimens processed Monday through Sunday
Results reported Monday through Friday
Report Available
1 to 11 daysSpecimen Retention Time
14 daysPerforming 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
88184-Flow Cytometry; first cell surface, cytoplasmic or nuclear marker
88185 x 5-Flow Cytometry, additional cell surface, cytoplasmic or nuclear marker (each)
LOINC Code Information
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 607682 | MPCDS Pre-Analysis Cell Sort | No LOINC Needed |
| 607688 | Final Diagnosis | No LOINC Needed |