Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders
Sorting plasma cells for fluorescence in situ hybridization analysis
Only orderable as a reflex. See PCPDS / Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow
Flow Cytometric Cell Selection
Bone Marrow
Only orderable as a reflex. See PCPDS / Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow
Specimen Type: Bone marrow
Preferred: Yellow top (ACD solution A or B)
Acceptable: Lavender top (EDTA) or green top (heparin)
Specimen Volume: 4 mL
Collection Instructions:
1. Invert several times to mix bone marrow
2. Send bone marrow specimen in original tube. Do not aliquot.
2 mL
Gross hemolysis | Reject |
Other | Fully clotted |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Bone Marrow | Ambient (preferred) | 4 days | |
Refrigerated | 4 days |
Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders
Sorting plasma cells for fluorescence in situ hybridization analysis
Multiple myeloma is a hematologic neoplasm that generally originates in the bone marrow and develops from malignant plasma cells. There are four main categories of plasma cell proliferative disorders: monoclonal gammopathy of undetermined significance (MGUS), monoclonal immunoglobulin deposition diseases (amyloidosis), plasmacytoma, and multiple myeloma. MGUS, which occurs in 3% to 4% of individuals over age 50 years, represents the identification of an asymptomatic monoclonal protein, yet approximately 1% per year will progress to multiple myeloma. Amyloidosis represents a rare group of deposition disorders including primary amyloidosis vs. light chain and heavy chain disease. Plasmacytomas represent isolated collections of bone or extramedullary plasma cells with a risk for development of multiple myeloma. Generalized bone pain, anemia, limb numbness or weakness, symptoms of hypercalcemia, and recurrent infections are all symptoms that may indicate multiple myeloma.
As myeloma progresses, the malignant plasma cells interfere with normal blood product formation in the bone marrow resulting in anemia and leukopenia. Myeloma also causes an overstimulation of osteoclasts, causing excessive breakdown of bone tissue without the normal corresponding bone formation. These bone lesions are seen in approximately 66% of myeloma patients. In advanced disease, bone loss may reach a degree where the patient suffers fractures easily.
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.
Only orderable as a reflex. See PCPDS / Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow
An interpretive report will be provided.
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.
No significant cautionary statements
1 Swerdlow S, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. IARC Press; 2017
2. 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
3. Rajkumar SV, Landgren O, Mateos MV. Smoldering multiple myeloma. Blood. 2015 May 14;125(20):3069-3075. doi:10.1182/blood-2014-09-568899
4. Muchtar E, Dispenzieri A, Kumar S et al. Interphase fluorescence in situ hybridization in untreated AL amyloidosis has an independent prognostic impact by abnormality type and treatment category. Leukemia. 2017;31(7);1562-1569. doi: 10.1038/leu.2016.369
5. Lakshman A, Paul S, Rajkumar SV et al. Prognostic significance of interphase FISH in monoclonal gammopathy of undetermined significance. Leukemia. 2018;32(8);1811-1815. doi: 10.1038/s41375-018-0030-3
6. Bochtler T, Hegenbart U, Kunz C, et al. Prognostic impact of cytogenetic aberrations in AL amyloidosis patients after high-dose melphalan: a long-term follow-up study. Blood. 2016;128(4):594-602. doi:10.1182/blood-2015-10-7
7. Treatment guidelines: multiple myeloma. mSMART 3.0. Accessed October 27, 2023. Available at www.msmart.org/mm-treatment-guidelines
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 assessment.(Instruction manual: BD FACSMelody Cell Sorter User's Guide. Revision 3. BD Biosciences; 03/2020)
Specimens processed: Monday through Sunday
Results reported: Monday through Friday
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.
88184-Flow Cytometry; first cell surface, cytoplasmic or nuclear marker
88185 x 5-Flow Cytometry, additional cell surface, cytoplasmic or nuclear marker (each)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
CSPCF | PCPDS Pre-Analysis Cell Sorting, BM | No LOINC Needed |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
607684 | PCPDS Pre-Analysis Cell Sort | No LOINC Needed |
607689 | Final Diagnosis | No LOINC Needed |