Home
HelpTest ID: 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 with multiple myeloma or other plasma cell proliferative disorders, using a laboratory-designated probe set algorithm
Identifying prognostic markers associated with 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.
If sufficient plasma cells are identified, the 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
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 | ||
Clinical Information
Multiple myeloma is a hematologic neoplasm that generally originates in the bone marrow and develops from malignant plasma cells. There are 4 main categories of plasma cell proliferative disorders: monoclonal gammopathy of undetermined significance (MGUS), monoclonal immunoglobulin deposition diseases (amyloidosis), plasmacytoma, and multiple myeloma. MGUS, which occurs in 3% to 4% of individuals over age 50 years, represents the identification of an asymptomatic monoclonal protein, yet approximately 1% per year will progress to multiple myeloma. Amyloidosis represents a rare group of deposition disorders including primary amyloidosis vs. light-chain and heavy-chain disease. Plasmacytomas represent isolated collections of bone or extramedullary plasma cells with a risk for development of multiple myeloma. Generalized bone pain, anemia, limb numbness or weakness, symptoms of hypercalcemia, and recurrent infections are all symptoms that may indicate multiple myeloma.
As myeloma progresses, the malignant plasma cells interfere with normal blood product formation in the bone marrow, resulting in anemia and leukopenia. Myeloma also causes an overstimulation of osteoclasts, causing excessive breakdown of bone tissue without the normal corresponding bone formation. These bone lesions are seen in approximately 66% of myeloma patients. In advanced disease, bone loss may reach a degree where the patient suffers fractures easily.
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. Patients with more aggressive multiple myeloma experience suboptimal responses to some therapeutic approaches; therefore, identifying these patients is critically important for selecting appropriate treatment options.
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.
Interpretation
A neoplastic clone is detected when the percentage of cells with an abnormality exceeds the normal reference range for any given probe set.
The absence of an abnormal clone does not rule out the presence of neoplastic disorder.
Clinical Reference
1. WHO Classification of Tumours Editorial Board, eds. Haematolymphoid tumours. 5th ed. IARC Press; 2024:603-630. WHO Classification of Tumours. Vol 11
2. Arber D., Borowitz, Cook J, et al. The International Consensus Classification of Myeloid and Lymphoid Neoplasms. Wolter Kluwer; 2025:384-396
3. Kumar SK, Rajkumar SV. The multiple myelomas-current concepts in cytogenetic classification and therapy. Nat Rev Clin Oncol. 2018;15(7):409-421. doi:10.1038/s41571-018-0018-y
4. Lu X, Andersen EF, Banerjee R, et al. Guidelines for the testing and reporting of cytogenetic results for risk stratification of multiple myeloma: a report of the Cancer Genomics Consortium Plasma Cell Neoplasm Working Group. Blood Cancer J. 2025;15(1):86
5. Gagnon MF, Midthun SM, Fangel JA, et al. Superior detection rate of plasma cell FISH using FACS-FISH. Am J Clin Pathol. 2024;161(1):60-70. doi:10.1093/ajcp/aqad108
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.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 |
mcl-fish