Sign in →

Order Code MPCDS mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow


Specimen Required


Only orderable as part of a profile. For more information see MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow.

 

Specimen Type: Redirected bone marrow

Preferred: Yellow top (ACD)

Acceptable: Lavender top (EDTA) or green top (heparin)

Specimen Volume: 4 mL


Useful For

Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders as a part of a profile

 

Identifying prognostic markers based on the anomalies found

Testing Algorithm

This test is designed for diagnostic specimens from patients with multiple myeloma or other plasma cell proliferative disorders.

 

For diagnostic samples, all probes in the initial panel will be evaluated if sufficient plasma cells are identified. The initial panel includes testing for the following the probes listed:

17p-, TP53/D17Z1

1q gain, TP73/1q22

14q32 rearrangement, IGH break-apart

8q24.1 rearrangement, MYC break-apart

 

Based on the results from the initial panel, reflex testing may be performed to identify the following abnormalities using the probes listed:

t(11;14)(q13;q32), CCND1/IGH fusion

t(14;16)(q32;q23) IGH/MAF fusion

t(4;14)(p16.3;q32) FGFR3/IGH fusion

t(14;20)(q32;q12) IGH/MAFB fusion

t(6;14)(p21;q32) CCND3/IGH fusion

 

Hyperdiploidy will be evaluated and reported by flow cytometry as part of this evaluation and incorporated into the final interpretation. For samples with an unsuccessful flow evaluation for hyperdiploidy and with sufficient plasma cells, fluorescence in situ hybridization testing for the following abnormalities will be performed using the probes listed:

+3/+7, D3Z1/D7Z1

+9/+15, D9Z1/D15Z4

 

For specimens sent for follow-up testing after completion of initial testing, the following probes will be evaluated if sufficient plasma cells are identified:

17p-, TP53/D17Z1

1q gain, TP73/1q22

8q24.1 rearrangement, MYC break-apart

 

Based on the results from the initial follow-up panel, reflex testing may be performed to identify the following high- risk abnormalities that were originally identified in the diagnostic specimen, using the probes listed:

t(14;16)(q32;q23) IGH/MAF fusion

t(4;14)(p16.3;q32) FGFR3/IGH fusion

t(14;20)(q32;q12) IGH/MAFB fusion

If a diagnostic sample was uninformative for a probe set due to an insufficient number of plasma cells, attempts may be made to achieve results for the missing probe on a subsequent sample (if sufficient plasma cells are identified).

 

Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.

Method Name

Only orderable as part of a profile. For more information see MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow.

 

Fluorescence In Situ Hybridization (FISH)

Reporting Name

mSMART Eval, PCPDs, FISH

Specimen Type

Bone Marrow

Specimen Minimum Volume

2 mL

Specimen Stability Information

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

Reject Due To

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

Reference Values

Only orderable as part of a profile. For more information see MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow.

 

An interpretive report will be provided.

Method Description

This test is performed using commercially available and laboratory-developed probes. Deletion or monosomy of chromosome 17, copy number gain of 1q, and additional copies of chromosomes 3, 7, 9, and 15 are detected using enumeration strategy probes. Translocations involving IGH are detected using dual-color, dual-fusion fluorescence in situ hybridization strategy probes. Rearrangement of IGH and MYC are detected using a break-apart strategy probe. For each probe set, 50 plasma cells (if possible) are scored and the result for each probe is reported. (Unpublished Mayo method)

Day(s) Performed

Monday through Friday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

88271 x 2, 88274, 88291-FISH Probe, Analysis, Interpretation; 1 probe set

88271 x 2, 88274-FISH Probe, Analysis; each additional probe set (if appropriate)

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
MPCDB Probe, Each Additional (MPCDS) No, (Bill Only) No