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HelpTest Code MSMRT Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow
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 |
Testing Algorithm
Based on the flow cytometric analysis and the presence of greater than or equal to 0.1% monotypic plasma cells, the pre-analysis cell sorting and fluorescence in situ hybridization for plasma cell proliferative disorders will be performed at an additional charge.
For more information see Multiple Myeloma: Laboratory Screening.
Method Name
Flow Cytometry/DNA Content/Cell Cycle Analysis
Specimen Type
Bone MarrowOrdering Guidance
This test should be ordered at diagnosis or for a known relapsing patient of multiple myeloma and when MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow is requested.
For follow-up of a plasma cell neoplasm (plasma cell proliferative disorder), order MSMRD / Myeloma Stratification and Risk-Adapted Therapy with Reflex to Minimal Residual Disease, Bone Marrow.
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) 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.
Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy (MSMRT) 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
Preanalytical processing: Monday through Saturday
Results reported: Monday through Friday
Report Available
1 to 11 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
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.