Consensus guidelines on plasma cell myeloma minimal residual disease analysis and reporting

Maria Arroz, Neil Came, Pei Lin, Weina Chen, Constance Yuan, Anand Lagoo, Mariela Monreal, Ruth de Tute, Jo Anne Vergilio, Andy C. Rawstron, Bruno Paiva

Research output: Contribution to journalArticle

66 Scopus citations


Background: Major heterogeneity between laboratories in flow cytometry (FC) minimal residual disease (MRD) testing in plasma cell (PC) myeloma (PCM) is an unfortunate reality. Cytometry societies such as the International Clinical Cytometry Society and the European Society for Clinical Cell Analysis recognize a strong need to establish minimally acceptable requirements and recommendations to perform such complex testing. Methods: A group of 11 flow cytometrists currently performing FC testing in PCM despite different instrumentation, myeloma using MRD panel designs (≥ 6-color) and analysis software compared the procedures in their laboratories and reviewed the available literature to propose a consensus guideline on PCM MRD analysis and reporting. Results/Conclusion: Consensus guidelines are to employ a minimum of four initial gating parameters (CD38, CD138, CD45, and light scatters) within the same tube for the identification of the total PC compartment; to subsequently analyze potentially aberrant surface markers (that are virtually always more informative than cytoplasmic light chain analysis); to report the antigen expression pattern on neoplastic PCs as being reduced, normal or increased, when compared to a normal reference PC immunophenotype (obtained using the same instrument and parameters), and the percentage of neoplastic PCs over total plasma Consensus guidelines on minimal current and future MRD analyses should target a lower limit of detection of 0.001%, and ideally a limit of quantification of 0.001%, which requires at least 3 × 10<sup>6</sup> and 0.5 × 10<sup>6</sup> bone marrow cells to be acquired, respectively.

Original languageEnglish (US)
JournalCytometry Part B - Clinical Cytometry
StateAccepted/In press - 2015


  • Flow cytometry
  • Minimal residual disease
  • Plasma cell myeloma

ASJC Scopus subject areas

  • Cell Biology
  • Histology
  • Pathology and Forensic Medicine

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    Arroz, M., Came, N., Lin, P., Chen, W., Yuan, C., Lagoo, A., Monreal, M., de Tute, R., Vergilio, J. A., Rawstron, A. C., & Paiva, B. (Accepted/In press). Consensus guidelines on plasma cell myeloma minimal residual disease analysis and reporting. Cytometry Part B - Clinical Cytometry.