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Test ID: SMART    
Mayo Stratification for Myeloma and Risk-Adapted Therapy Report

Method Description Describes how the test is performed and provides a method-specific reference

Chromosomes, mSMART Evaluation, Bone Marrow:

A cell count is performed on the specimen to establish a plating volume. Based on the cell count, a corresponding volume of bone marrow is added to 2 culture flasks containing culture medium and incubated for 24 to 48 hours at 37 degrees C. In the harvest process, the cells are exposed to colcemid, and hypotonic solution and fixed with glacial acid and methanol. Metaphases cells are dropped onto microscope slides and are routinely stained by G-banding, but other staining methods are frequently employed as needed. Twenty metaphases are usually examined. However, if a clone is suspected, but not confirmed within 20 metaphases, 30 metaphases will be analyzed. Minimal evidence for the presence of an abnormal clone is defined as 2 or more metaphases with the same structural abnormality or chromosome gain (trisomy), or 3 or more metaphases lacking the same chromosome. All cells analyzed are captured using a computerized imaging system, and 1 or more karyograms from each clone are prepared to document the type of abnormality and to permit systematic interpretation of the anomalies.(Dewald GW, Allen JE, Strutzenberg DK, Pierre RV: A cytogenetic method for mailed-in bone marrow specimens for the study of hematologic disorders. Lab Med 1982;13:225-229)


Plasma Cell Proliferative Disorder (PCPD), FISH:

This test uses commercially available and laboratory-developed chromosome-specific fluorescent-labeled DNA probes for FISH. Bone marrow samples are processed to keep the cytoplasm of the leukocytes intact. At least 2 slides with 2 hybridization sites each are prepared using a cytospin centrifuge. Each probe set is hybridized to a separate hybridization site. Plasma cells are specifically detected by using immunoglobulin staining techniques with commercially available antibodies (cIg) for kappa and lambda. Deletions or monosomies of chromosomes 13 and 17 are detected using FISH enumeration strategies. Centromere probes are used to detect chromosomal aneusomies for chromosomes 3, 7, 9, and 15. Translocation involving chromosome 14 (IGH) with chromosomes 4 (FGFR3), 11 (CCND1), or 16 (MAF) are detected by D-FISH strategies. For each probe set, 50 plasma cells (if possible) are scored and the result for each probe is reported.(Shaughnessy J, Tian E, Sawyer J, et al: High incidence of chromosome 13 deletion in multiple myeloma detected by multiprobe interphase FISH. Blood 2000 Aug 15;96[4]:1505-1511)


Plasma Cell DNA Content and Proliferation, Bone Marrow:

Flow cytometry

Supplemental Report Indicates whether the report includes an additional document with charts, images or other enriched information


Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.

Monday through Sunday

Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.

10 days

Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result


Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

See Individual Unit Codes

Performing Laboratory Location The location of the laboratory that performs the test