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Test Code PCPRO Plasma Cell DNA Content and Proliferation, Bone Marrow

Reporting Name

Plasma Cell Proliferation, Marrow

Useful For

Establishing a diagnosis of a plasma cell proliferative disorder

 

Providing prognostic information for newly diagnosed multiple myeloma and other plasma cell proliferative disorders

 

Assessing response to therapy and detecting disease relapse and progression in treated plasma cell proliferative disorder patients

 

Determining plasma cell DNA content and proliferation

Additional Tests

Test ID Reporting Name Available Separately Always Performed
FCINT Flow Cytometry Interp, 2-8 Markers No, (Bill Only) Yes

Testing Algorithm

When this test is ordered, flow cytometry interpretation will always be performed at an additional charge.

 

For more information see:

-Amyloidosis: Laboratory Approach to Diagnosis

-Multiple Myeloma: Laboratory Screening

Method Name

Flow Cytometry/DNA Content/Cell Cycle Analysis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Bone Marrow


Ordering Guidance


This test can be ordered at diagnosis or follow-up of a plasma cell neoplasm (plasma cell proliferative disorder).

 

If CSMRT / mSMART Plasma Cell Proliferative Disorder, Pre-Analysis Cell Sorting, Bone Marrow or MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow is desired to be performed at Mayo, order MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow.

 

The Multiple Myeloma: Laboratory Screening algorithm will allow plasma cell fluorescence in situ hybridization (FISH) testing to be added, based on this test's flow cytometry results.



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.



Specimen Required


Specimen Type: Redirected bone marrow

Preferred: Yellow top (ACD solution A or B)

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

Specimen Volume: 4 mL

Specimen Stability Information: 3 days


Specimen Minimum Volume

2 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis Reject
Fully clotted Reject

Reference Values

Plasma Cell Clonality:

Normal bone marrow

No monotypic clonal plasma cells detected

 

DNA Index:

Normal polytypic plasma cells

DNA index (G0/G1 cells): Diploid 0.95-1.05

Day(s) Performed

Preanalytical processing: Monday through Saturday

Results reported: Monday through Friday

CPT Code Information

88182-Flow cytometry, cell cycle or DNA analysis

88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker

88185 x 5-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each)

88187-Flow cytometry interpretation, 2 to 8 Markers (added as FCINT)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PCPRO Plasma Cell Proliferation, Marrow 93363-0

 

Result ID Test Result Name Result LOINC Value
CK056 Monotypic Plasma Cells: 93362-2
CK057 Monotypic PC per Total Events 93021-4
CK058 Monotypic Plasma Cells S-phase 93361-4
CK059 Monotypic Plasma Cells DNA Index 93360-6
CK060 Monotypic Plasma Cells DNA Ploidy 93359-8
CK061 Polytypic PC per Total Events 93358-0
CK062 Polytypic PC per All Plasma Cells 93020-6
CK063 Final Diagnosis 50398-7

Clinical Information

Plasma cell proliferative disorders are a group of plasma cell derived clonal hematologic neoplasms that exhibit a wide range of biologic activity ranging from monoclonal gammopathy of uncertain significance (MGUS), a usually indolent disorder with a low rate of disease progression, to multiple myeloma (MM), a disease that is often aggressive with poor long-term survival. Detecting plasma cell clonality through demonstrating immunoglobulin (Ig) light chain restriction (ie, the presence of either predominately kappa or predominately lambda light chains), supplemented by the plasma cell immunophenotype and DNA index, is an important element in establishing the diagnosis.

 

It is important to correctly classify patients with plasma cell proliferative disorders as the various disease entities are treated differently. A number of factors are used for this classification including the proportions of clonal bone marrow plasma cells, the DNA index of the clonal plasma cells, and their proliferative activity. The plasma cell DNA index and proliferation assessment by flow cytometry are rapid and reliable. This information can be used to distinguish patients with overt active MM from less aggressive diseases such as MGUS and smoldering MM.

 

Furthermore, in combination with other laboratory data, the results of these studies can be used as a measure of disease aggressiveness in newly diagnosed MM and to determine therapeutic efficacy and detect disease relapse in treated MM patients.

 

The following algorithms are available:

-Amyloidosis: Laboratory Approach to Diagnosis

-Multiple Myeloma: Laboratory Screening

Specimen Retention Time

14 days

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

Report Available

1 to 4 days

Forms

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