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HelpTest ID: NGPCM MayoComplete Plasma Cell Myeloma, Next-Generation Sequencing, Varies
Shipping Instructions
Bone marrow aspirate samples must arrive within 4 days of collection.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Bone marrow aspirate
Container/Tube: Lavender or pink top (EDTA) or yellow top (ACD)
Specimen Volume: 2 mL
Collection Instructions:
1. Minimum plasma cell percentage is 5%.
2. Invert several times to mix bone marrow.
3. Send bone marrow specimen in original tube. Do not aliquot.
4. Label specimen as bone marrow.
5. Fresh specimen is required for this test, as testing is performed on sorted cells.
Specimen Stability Information: Ambient (preferred) 4 days/Refrigerate
Additional Information: To ensure minimum volume and concentration of DNA are met, the requested volume must be submitted. Testing may be canceled if DNA requirements are inadequate.
Specimen Type: Paraffin-embedded bone marrow clot
Container/Tube: Paraffin block
1. Send 1 hematoxylin and eosin-stained slide in addition to the paraffin block.
2. Minimum plasma cell percentage is 20%.
3. Required amount of tissue area is at least 25 mm(2).
4. Tissue should be fixed in 10% neutral-buffered formalin. Other fixatives are not acceptable.
5. Decalcified specimens (eg, bone marrow core biopsies) are not acceptable.
Specimen Stability Information: Ambient
Additional Information: If the quality of the specimen is poor or the plasma cell population is below 20%, testing should not be ordered. Testing may be canceled if DNA requirements are inadequate.
Specimen Type: Tissue slide, bone marrow clot
Slides: 10 unstained slides
Container/Tube: Transport in plastic slide holders.
Collection Instructions:
1. Send 10 unstained, nonbaked slides with 5-micron thick sections of tissue and 1 hematoxylin and eosin-stained slide.
2. Minimum amount of plasma cell percentage is 20%.
4. Required amount of tissue area is at least 25 mm(2).
5. Tissue should be fixed in 10% neutral-buffered formalin. Other fixatives are not acceptable.
6. Decalcified specimens (eg, bone marrow core biopsies) are not acceptable.
Specimen Stability Information: Ambient
Additional Information: Testing may be canceled if resultant extracted DNA does not meet concentration requirements.
Forms
1. Hematopathology Patient Information (T676)
2. If not ordering electronically, complete, print, and send an Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Useful For
Evaluating multiple myeloma at the time of diagnosis and at disease relapse or when changing clinical management to provide prognostic information and determine potential therapeutic implications
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CSPMM | NGPCM Pre-Analysis Cell Sorting, BM | No | No |
Testing Algorithm
For a list of the genes and exons targeted by this assay, see Targeted Genes Interrogated by MayoComplete Plasma Cell Myeloma Next-Generation Sequencing.
Special Instructions
Method Name
Next-Generation Sequencing (NGS)
Reporting Name
Plasma Cell Myeloma, NGS, VSpecimen Type
VariesSpecimen Minimum Volume
Bone marrow aspirate: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Varies | |
Clinical Information
Multiple myeloma (MM) is a malignancy of bone marrow plasma cells with an annual global incidence of nearly 200,000. Comprehensive clinical, radiologic, and laboratory evaluation can initially stratify patients by disease phase and burden. Cytogenetic and fluorescence in situ hybridization studies are important to help classify MM into standard, intermediate, and high-risk groups. Advances in nontargeted therapies, including autologous bone marrow transplantation, have significantly improved the outcome of many patients; however, most patients with myeloma suffer relapse after initial treatment. Clinical next-generation sequencing (NGS) technology has enabled a deeper and more detailed evaluation of MM genetics. Testing allows for further risk categorization of the disease through the identification of additional genetic abnormalities of prognostic and potentially therapeutic value. Application of targeted NGS-based analysis is a useful adjunct to the standard evaluation of MM patients at diagnosis and relapse. This test comprises a DNA-based multigene panel that includes preanalytic plasma cell enrichment, NGS, and detailed analysis, resulting in a clinical report.
Reference Values
An interpretive report will be provided.
Interpretation
Genomic variants detected by this test will be documented in a detailed laboratory-issued report. This report will contain information regarding the detected alterations and their associations with prognosis or possible therapeutic implications in plasma cell myeloma. The information in the clinical report may be used by the patient’s clinician to help guide decisions concerning management. Final interpretation of next-generation sequencing results requires correlation with all relevant clinical, pathologic, and laboratory findings and is the responsibility of the managing clinician.
Clinical Reference
1. Swerdlow S, Campo E, Harris NL, et al, eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. IARC Press; 2017. WHO Classification of Tumours, Vol 2
2. Onaindia A, Medeiros LJ, Patel KP. Clinical utility of recently identified diagnostic, prognostic, and predictive molecular biomarkers in mature B-cell neoplasms. Mod Pathol. 2017;30(10):1338-1366. doi:10.1038/modpathol.2017.58
3. Walker BA, Mavrommatis K, Wardell CP, et al. Identification of novel mutational drivers reveals oncogene dependencies in multiple myeloma. Blood. 2018;132(6):587-597. doi:10.1182/blood-2018-03-840132
4. Walker BA, Boyle EM, Wardell CP, et al. Mutational spectrum, copy number changes, and outcome: Results of a sequencing study of patients with newly diagnosed myeloma. J Clin Oncol. 2015;33(33):3911-20. doi:10.1200/JCO.2014.59.1503
5. Kortuem KM, Braggio E, Bruins L, et al. Panel sequencing for clinically oriented variant screening and copy number detection in 142 untreated multiple myeloma patients. Blood Cancer J. 2016;6(2):e397. doi:10.1038/bcj.2016.1
6. Jimenez C, Jara-Acevedo M, Corchete LA, et al. A next-generation sequencing strategy for evaluating the most common genetic abnormalities in multiple myeloma. J Mol Diagn. 2017;19(1):99-106
7. Yellapantula V, Hultcrantz M, Rustad EH, et al. Comprehensive detection of recurring genomic abnormalities: a targeted sequencing approach for multiple myeloma. Blood Cancer J. 2019;9(12):101. doi:10.1038/s41408-019-0264-y
8. Cutler SD, Knopf P, Campbell CJV, et al. DMG26 A targeted sequencing panel for mutation profiling to address gaps in the prognostication of multiple myeloma. J Mol Diagn. 2021;23(12):1699-1714
Day(s) Performed
Monday through Friday
Report Available
16 to 21 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
81450
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| NGPCM | Plasma Cell Myeloma, NGS, V | 104241-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| MP074 | Specimen Type | 31208-2 |
| MP075 | Indication for Test | 42349-1 |
| 618515 | NGPCM Result | No LOINC Needed |
| 618516 | Pathogenic Mutations Detected | 82939-0 |
| 618517 | Interpretation | 69047-9 |
| 618519 | Variants of Unknown Significance | 93367-1 |
| 618520 | Additional Information | 48767-8 |
| 618518 | Clinical Trials | 82786-5 |
| 618521 | Method Summary | 85069-3 |
| 618522 | Disclaimer | 62364-5 |
| 618523 | Panel Gene List | 36908-2 |
| 618524 | Reviewed By | 18771-6 |
mml-myeloma