Ordering Guidance

For plasma cell proliferative disorders such as multiple myeloma, fluorescence in situ hybridization (FISH) studies will detect chromosome anomalies with prognostic significance much more often than conventional chromosome studies. The recommended test in this situation is PCPDS / Plasma Cell Proliferative Disorder, High-Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow.

If this test is ordered and the laboratory is informed that the patient is on a Children's Oncology Group (COG) protocol, this test will be canceled and automatically reordered by the laboratory as COGBM / Chromosome Analysis, Hematologic Disorders, Children's Oncology Group Enrollment Testing, Bone Marrow.

Due to limited clinical utility, chromosome analysis is not recommended for plasma cell neoplasms.(1)

If this test and a plasma cell FISH test (PCPDS / Plasma Cell Proliferative Disorder, High-Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow; MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow; or MFCDF / Myeloma High Risk with Reflex Probes, Diagnostic FISH Evaluation, Fixed Cell Pellet) are ordered concurrently, this test will be canceled.

If a secondary myeloid neoplasm is suspected and both this test and a plasma cell FISH (PCPDS/MSMRT/MFCDF) are needed, contact the Cytogenetics Communication Team at 800-533-1710 before sending the specimen.

Shipping Instructions

Advise Express Mail or equivalent if not on courier service.

Necessary Information

1. A reason for testing should be submitted with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.

2. A pathology and/or flow cytometry report may be requested by the laboratory to optimize testing and aid in interpretation of results.

3. If a patient has received an opposite sex bone marrow transplant prior to specimen collection, note this information on the request.

Specimen Required

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (sodium heparin) or lavender top (EDTA)

Specimen Volume: 2 to 3 mL

Collection Instructions:

1. It is preferable to send the first aspirate from the bone marrow collection.

2. Invert several times to mix bone marrow.