• CD19
• CD20
• CD38
• CD45
• CD56
• IRF4 (nuclear)
• Kappa (cytoplasmic)
• Lambda(cytoplasmic)
• VS38(cytoplasmic)

Detecting residual disease in treated multiple myeloma patients at follow-up

Pathology orders only

The P2 assay is a high-sensitivity assay validated to a sensitivity of 0.01% (1 abnormal plasma cell/10,000 normal cells). This assay is NOT a minimal/measureable residual (MRD) assay, which requires a validated sensitivity of 0.001% (1/100,000). For follow-up of patients who are negative for residual abnormal plasma cells in the P2 assay, we recommend EDTA-anticoagulated bone marrow aspirate be submitted to the Mayo Clinic Laboratories for formal MRD testing (Mayo Clinic Laboratories test code: MRDMM).

Heparinized syringe

Collect 3.0 mL (minimum 1.0mL) bone marrow aspirate in a sodium heparinized syringe and transfer to an anticoagulant free tube.

Bone marrow specimen transport kit

Bone marrow transport vial/tube, 8mL or

Falcon vial/tube - 15mL

RPMI with Hepes/Pen strep/FBS -15 mL

• If you do not use a heparinized syringe, collect 3.0 mL (minimum 1.0mL) bone marrow aspirate and transfer to a Dk green Sodium heparin (Na hep), no gel (preferred) or a Lavender (EDTA), 4mL (acceptable) 
• Mix sample thoroughly by gently inverting 8 - 10 times to prevent clotting

Bone marrow aspirate:

If you do not use a heparinized syringe to collect the sample:

Dk green Sodium heparin (Na hep), no gel (preferred)

Lavender (EDTA), 4mL (acceptable)

Immediately following collection, mix sample thoroughly by gently inverting 8 - 10 times to prevent clotting

Bone marrow core:

RPMI with Hepes/Pen strep/FBS -15 mL

Complete the "Brief clinical information" and "What do you want answered by Flow?" areas on the Flow cytometry requisition

Ambient (preferred) - 72 hours

Refrigerated (discouraged)

Frozen - NO

• Improper labels (unlabeled or mislabeled)
• Improper anticoagulant or ratio
• Delay in transport
• Improper storage temperature affecting results
• Improper container
• Leaking container resulting in compromised specimen
• Quantity not sufficient (QNS)

Flow cytometry

Tubes:

P2

Markers:

CD19, CD20, CD38, CD45, CD56, IRF4 (nuclear), Kappa (cytoplasmic), Lambda (cytoplasmic) and VS38 (cytoplasmic).