Diagnosis and risk stratification

An algorithmic approach to guide diagnosis

Our updated approach to fluorescence in-situ hybridization (FISH) testing takes into account the fact that multiple myeloma is increasingly recognized as more than one disease, and is characterized by cytogenetic, molecular, and proliferative heterogeneity. While novel agents and combinations are rapidly redefining the treatment paradigm, patient outcomes vary based on risk stratification.

Created in conjunction with Mayo Clinic’s multiple myeloma clinical practice, mSMART uses flow cytometry, FISH, and the latest consensus to determine a patient’s genetic risk of developing multiple myeloma. This approach better informs individualized treatment plans and provides clinicians with a comprehensive and correlated patient profile.

Comprehensive testing, simplified

In addition to mSmart evaluation, Mayo Clinic Laboratories now offers comprehensive FISH testing for diagnosis and risk stratification of multiple myeloma. Our approach to fluorescence in situ hybridization (FISH)testing is designed to simplify the ordering process by providing diagnostic panels that include all appropriate genes.

Key testing

MSMRT | Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow

  • Risk stratification of patients with multiple myeloma, which can assist in determining treatment and management decisions
  • Includes reflex testing to FISH when appropriate:

MFCDF | Myeloma Fixed Cell, High Risk, FISH

  • When ordered, entire high-risk MFC FISH panel will be performed

PCPDS | Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow

  • When ordered, entire high-risk PCPD FISH panel will be performed

Updated testing algorithms for plasma cell proliferative disorders

Xinjie Xu, Ph.D., co-director of Mayo Clinic's Genetics and Genomics Laboratory, explains Mayo Clinic Laboratories' updated approach to testing for risk stratification of patients newly diagnosed with plasma cell proliferative disorders, such as multiple myeloma. Based on recently published data, the new testing algorithms focus on use of fluorescence in-situ hybridization (FISH) panels, rather than chromosome studies.

A comparison of testing approaches

Learn more about how to order these evaluations at your institution.

Additional resources

mSMART: Stratification for myeloma and risk-adapted therapy

The group's mission is to present the state-of-the-art approach to management of these plasma cells disorders including myeloma, amyloidosis, and Waldenstrom macroglobulinemia. Views expressed here are opinions of a group of experts, based on best available evidence.