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HelpOrder 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
Detecting, at diagnosis, recurrent common high-risk chromosome abnormalities associated multiple myeloma or other plasma cell proliferative disorders, using a laboratory-designated probe set algorithm
Identifying prognostic markers associated multiple myeloma or other plasma cell proliferative disorders
Testing Algorithm
This test includes a charge for the probe application, analysis, and professional interpretation of results for 1 probe set (2 individual fluorescence in situ hybridization [FISH] probes) on pre-sorted plasma cells. Additional charges will be incurred for all reflex or additional probe sets performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If an insufficient number of plasma cells are available for analysis, no analysis charges will be incurred.
This test is performed using either the diagnostic or follow-up analysis algorithm.
If sufficient plasma cells are identified, the diagnostic plasma cell FISH panel includes testing for the following abnormalities using the FISH probes listed:
1p loss/1q gain, CDKN2C/1q22 probe set
t(8q24.21;var) or MYC rearrangement, MYC break-apart probe set
t(14q32;var) or IGH rearrangement, IGH break-apart probe set
-17/17p-, TP53/D17Z1 probe set
If an IGH rearrangement is identified, appropriate reflex testing will be performed in an attempt to identify the translocation partner using the FISH probes listed:
t(4;14)(p16.3;q32) IGH::FGFR3 fusion, FGFR3/IGH probe set
t(6;14)(p21;q32) IGH::CCND3 fusion, CCND3/IGH probe set
t(11;14)(q13;q32) or IGH::CCND1 fusion, CCND1/IGH probe set
t(14;16)(q32;q23) IGH::MAF fusion, IGH/MAF probe set
t(14;20)(q32;q12) IGH::MAFB fusion, IGH/MAFB probe set
Hyperdiploidy, as determined by flow cytometry, will be incorporated into the final interpretation. For samples with an unsuccessful flow evaluation for hyperdiploidy and sufficient plasma cells, FISH testing for the following abnormalities will be performed using the probes listed:
+3 (trisomy 3) and/or +7 (trisomy 7), D3Z1/D7Z1 probe set
+9 (trisomy 9) and/or +15 (trisomy 15), D9Z1/D15Z4 probe set
If sufficient plasma cells are identified, the follow-up plasma cell FISH panel includes testing for the following abnormalities using the FISH probes listed:
1p deletion/1q gain, CDKN2C/1q22 probe set
t(8q24.21;var) or MYC rearrangement, MYC break-apart probe set
-17/17p-, TP53/D17Z1 probe set
If no abnormalities are observed in the follow-up myeloma FISH panel, reflex testing may be performed to identify the following high-risk abnormalities, if originally identified in the diagnostic specimen, using the probes listed:
t(4;14)(p16.3;q32) IGH::FGFR3 fusion, FGFR3/IGH probe set
t(14;16)(q32;q23) IGH::MAF fusion, IGH/MAF probe set
t(14;20)(q32;q12) IGH::MAFB fusion, IGH/MAFB probe set
Follow-up testing is determined by the results of previous MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow testing, reported at this laboratory.
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, FISHSpecimen Type
Bone MarrowSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| 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 on sorted plasma cells. Deletion of the TP53 locus from chromosome 17 or monosomy 17 and deletion of the CDKN2C locus or gain of the 1q22 locus are detected using enumeration strategy probe sets. If necessary, hyperdiploidy will be assessed using enumeration strategy probe sets for chromosomes 3, 7, 9, and 15. Rearrangements involving IGH and MYC are detected using dual-color break-apart strategy probe sets. Dual-color, dual-fusion fluorescence in situ hybridization strategy probe sets are used when a rearrangement of the IGH gene is detected. 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)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MPCDS | mSMART Eval, PCPDs, FISH | 93357-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 606091 | mSMART Result Summary | 62357-9 |
| 606092 | mSMART Evaluation | 57802-1 |
| 606093 | Interpretation | 69965-2 |
| 606094 | Result Table | 93356-4 |
| 606095 | Result | 62356-1 |
| 606096 | Reason for Referral | 42349-1 |
| 606097 | Specimen | 31208-2 |
| 606098 | Source | 85298-8 |
| 606099 | Method | 85069-3 |
| 606100 | Additional Information | 48767-8 |
| 606101 | Disclaimer | 62364-5 |
| 606102 | Released By | 18771-6 |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| MPCDB | Probe, Each Additional (MPCDS) | No, (Bill Only) | No |