Test Catalog

Test ID: CSPCF    
Plasma Cell Proliferative Disorder, Pre-Analysis Cell Sorting, Bone Marrow


Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders


Sorting plasma cells for FISH analysis


Multiple myeloma is a hematologic neoplasm that generally originates in the bone marrow and develops from malignant plasma cells. There are four main categories of plasma cell proliferative disorders (PCPD): 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. Multiple myeloma patients with more aggressive disease experience suboptimal responses to some therapeutic approaches; therefore, identifying these patients is critically important for selecting appropriate treatment options.


Only orderable as a reflex. See PCPDS / Plasma Cell Proliferative Disorder, FISH, Bone Marrow


An interpretive report will be provided.

Interpretation Provides information to assist in interpretation of the test results

Correlation with clinical, histopathologic and additional laboratory findings is required for final interpretation of these results. The final interpretation of results for clinical management of the patient is the responsibility of the managing physician.


No significant cautionary statements

Clinical Reference Recommendations for in-depth reading of a clinical nature

1 Swerdlow S, Campo E, Harris NL, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press: Lyon. 2017

2. 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

3. Rajkumar SV, Landgren O, Mateos MV: Smoldering multiple myeloma. Blood 2015 May 14;125(20):3069-3075 doi:10.1182/blood-2014-09-568899

4. Muchtar E, Dispenzieri A, Kumar S et al: Interphase fluorescence in situ hybridization in untreated AL amyloidosis has an independent prognostic impact by abnormality type and treatment category. Leukemia 2017 Jul;31(7);1562-1569 doi:10.1038/leu.2016.369

5. Lakshman A, Paul S, Rajkumar SV et al: Prognostic significance of interphase FISH in monoclonal gammopathy of undetermined significance. Leukemia 2018 Aug;32(8);1811-1815 doi:10.1038/s41375-018-0030-3

6. Bochtler T, Hegenbart U, Kunz C, et al: Prognostic impact of cytogenetic aberrations in AL amyloidosis patients after high-dose melphalan: a long-term follow-up study. Blood 2016 Jul 28;128(4):594-602 doi.org/10.1182/blood-2015-10-7.

7. mSMART 3.0, Accessed 01/16/2020. www.msmart.org/mm-treatment-guidelines