Test Catalog

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

Method Description Describes how the test is performed and provides a method-specific reference

Flow cytometric immunophenotyping of bone marrow is performed using the following antibodies; CD19, CD38, CD45, CD138, cytoplasmic kappa and lambda immunoglobulin, and DAPI. Plasma cell clonality is detected through demonstrating CD38 and CD138 positivity along with immunoglobulin light chain restriction (ie, the presence of either predominately kappa or predominately lambda light chains) and abnormality of CD19 and/or CD45 expression. DNA index of clonal plasma cells and their proliferation activity is determined through staining of double-stranded DNA using DAPI.


Plasma cells (monoclonal/monotypic and polyclonal/polytypic) are detected by immunoglobulin light chain restriction, surface immunophenotype, and DNA content. If present, the light chain expressed by the monotypic plasma cells is indicated. The percentage of clonal plasma cells estimated by flow cytometry is affected by specimen processing and antigen loss with specimen aging. Manual differential counting remains the accepted standard for determining the bone marrow plasma cell percentage. The percentage of monotypic plasma cells in S-phase of the cell cycle is determined by quantitative DNA analysis. The DNA index is a calculated value. The presence of more than 1 value indicates the presence of cell populations with differing DNA contents within the monotypic plasma cells.(Dispenzieri A, Buadi F, Kumar SK, et al. Treatment of Immunoglobulin Light Chain Amyloidosis: Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Statement. Mayo Clin Proc. 2015;90(8):1054–1081. doi:10.1016/j.mayocp.2015.06.009)


Plasma Cell Proliferative Disorder (PCPD):

This test is performed using both commercially available and laboratory developed probes. Deletion or monosomy of chromosomes 13 and 17 and copy number gain of 1q are detected using enumeration strategy probes. Centromere probes are used to detect chromosomal gain of chromosomes 3, 7, 9, and 15. Translocations involving IGH with FGFR3, CCND1, CCND3, MAF, and MAFB are detected using dual-color, dual-fusion (D-FISH) strategy probes. Rearrangement of IGH and MYC are detected using a break-apart strategy (BAP) probe. For each probe set, 50 plasma cells (if possible) are scored and the result for each probe is reported.(Unpublished Mayo method)

PDF Report Indicates whether the report includes an additional document with charts, images or other enriched information


Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.

Specimens are processed Monday through Sunday.

Results reported Monday through Friday 8 a.m.-5 p.m.

Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.

1 day with no reflex testing

Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Clinic Laboratories until the release of the test result

11 days if reflex testing performed

Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location Indicates the location of the laboratory that performs the test