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Test Code MRDMM Multiple Myeloma Minimal Residual Disease, Flow Cytometry, Bone Marrow

Reporting Name

Multiple Myeloma MRD by Flow, BM

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Detecting low level (minimal residual disease) myeloma cells after therapy.

Method Name

Immunophenotyping for Minimal Residual Disease (MRD)


Ordering Guidance


This test should be ordered on patients treated for multiple myeloma to confirm remission has been achieved, annual follow-up of those in remission, or in uncertain remission.

 

This test should not be ordered on known relapsing patients or at diagnosis. For these situations or if fluorescence in situ hybridization is requested, order either PCPRO / Plasma Cell DNA Content and Proliferation, Bone Marrow or MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow



Shipping Instructions


It is recommended that specimens arrive within 2 days of collection. Collect and package specimen as close to shipping time as possible.



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.

3. Provide Immunofix information if available.



Specimen Required


Specimen Type: Redirected bone marrow

Container/Tube:

Preferred: Yellow top (ACD solution A or B)

Acceptable: Lavender top (EDTA)

Specimen Volume: 4 mL


Specimen Type

Bone Marrow

Specimen Minimum Volume

2 mL

Specimen Stability Information

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

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability

Reference Values

An interpretive report will be provided.

 

Interpretation

The interpretation of the test is done by evaluating automated and manually gated populations to isolate abnormal plasma cells. If there is an abnormal plasma cell population (cluster of 20 cells or more), then the result is minimal residual disease (MRD)-positive, with the percentage of abnormal plasma cells out of total analyzed events. If no abnormal population is found, then the result will be interpreted as MRD-negative.

 

This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and correlation with the previous patient history will be provided by a hematopathologist for every case.

Day(s) Performed

Preanalytical processing: Monday through Saturday

Results reported: Monday through Friday

Report Available

2 to 4 days

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 9-Flow Cytometry; additional cell surface, cytoplasmic or nuclear marker

88188-Flow Cytometry Interpretation, 9 to 15 Markers

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MRDMM Multiple Myeloma MRD by Flow, BM 93022-2

 

Result ID Test Result Name Result LOINC Value
CK146 % Minimal Residual Disease (MRD) 93021-4
CK147 % Normal Plasma Cells (of total PC) 93020-6
CK148 Non-Aggregate Events 38257-2
CK149 Total Plasma Cell Events 93019-8
CK150 Poly PC Events 93018-0
CK151 Abnormal PC Events 93017-2
615796 % B-cell Precursors 101131-1
615797 % Mast Cells 101130-3
616082 Validated Assay Sensitivity 101129-5
616083 Lower Limit of Quantitation (LLOQ) 87706-8
615798 Patient / Sample Theoretical LOQ 101128-7
CK152 Final Diagnosis 74226-2

Forms

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