Test Code MSMRT Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow
Useful For
Risk stratification of patients with multiple myeloma, which can assist in determining treatment and management decisions
Risk stratification of patients with newly diagnosed multiple myeloma
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
CSMRT | MPCDS Pre-Analysis Cell Sorting, BM | No | No |
MPCDS | mSMART Eval, PCPDs, FISH | No | No |
Testing Algorithm
Based on the flow cytometric analysis and presence of greater than or equal to 0.1% monotypic plasma cells, the pre-analysis cell sorting and FISH for plasma cell proliferative disorder will be reflexed and performed at an additional charge.
This test is designed for diagnostic specimens. If a request for testing has been submitted within 12 months of a complete and informative plasma cell proliferative disorder FISH study, the current test request will be cancelled.
See Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.
Special Instructions
Method Name
Flow Cytometry/DNA Content/Cell Cycle Analysis
Reporting Name
mSMART Algorithmic Testing, BMSpecimen Type
Bone MarrowAdvisory Information
This test should be ordered at diagnosis of multiple myeloma and when MPCDS / mSMART, Plasma Cell Proliferative Disorder (PCPD), FISH is warranted based on the Laboratory Screening Tests for Suspected Multiple Myeloma algorithm.
This test is designed for diagnostic specimens. If follow-up testing is ordered within 12 months of a complete and informative PCPDS / Plasma Cell Proliferative Disorder, FISH, Bone Marrow result, the testing will be cancelled. If follow up testing is ordered within 12 months of an initial partial or insufficient study, the testing will proceed.
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)
Acceptable: Lavender top (EDTA) or green top (heparin)
Specimen Volume: 4 mL
Specimen Minimum Volume
3 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Bone Marrow | Ambient (preferred) | 72 hours | |
Refrigerated | 72 hours |
Reject Due To
Gross hemolysis | Reject |
Other | Fully clotted |
Clinical Information
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.
Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy (MSMRT) classifies patients into either standard or high-risk categories based on the results of 2 assays: plasma cell proliferation and FISH for specific multiple myeloma-associated abnormalities.
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) and Time(s) Performed
Specimens are processed Monday through Sunday.
Results reported Monday through Friday 8 a.m.-5 p.m.
Analytic Time
1 day with no reflex testingPerforming Laboratory

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 U.S. Food and Drug Administration.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
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
MSMRT | mSMART Algorithmic Testing, BM | 93357-2 |
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 |
CK134 | Final Diagnosis | 22637-3 |
NY State Approved
YesForms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.