Minimal Residual Disease (MRD) Monitoring for Multiple Myeloma Test
Short Name: MRD Monitoring for Multiple Myeloma
Also known as: MRD Test for Myeloma, Multiple Myeloma MRD Flow Cytometry, Myeloma Residual Disease Monitoring, MRD Assessment for Plasma Cell Myeloma
Minimal Residual Disease (MRD) Monitoring for Multiple Myeloma Test test available at DNA Labs India for ₹16,000. Uses Multiparameter Flow Cytometry on Bone Marrow Aspirate samples. Results in Report available within 3 working days from sample receipt. Sample collection: Daily by 9 AM.. Free home collection in 300+ cities across India.
🩺 Medically Reviewed By
Dr Pasupathy Arumugam
Consultant Pathologist · Reg: 21521
Last reviewed: September 7, 2026
Overview
The purpose of the MRD Monitoring test for Multiple Myeloma is to detect and quantify residual malignant plasma cells in the bone marrow at very low levels that are undetectable by conventional morphological or immunohistochemical methods. This test serves several critical purposes: assessing treatment response after induction, consolidation, or maintenance therapy; predicting progression-free survival and overall survival; guiding decisions regarding treatment intensification, de-escalation, or discontinuation; monitoring disease status during long-term follow-up; identifying early molecular relapse before clinical progression; and evaluating the depth of remission to determine eligibility for clinical trials.
- Test Code
- 1249
- CPT Code
- 88184
- ICD Code
- C90.0
- Price
- ₹16,000
- Sample Type
- Bone Marrow Aspirate
- Result Time
- Report available within 3 working days from sample receipt. Sample collection: Daily by 9 AM.
- Fasting Required
- No
- Method
- Multiparameter Flow Cytometry
Sample Collection
The patient should be informed about the procedure. Mandatory pre-test information must be provided including: sample time point (chemotherapy time points), previous diagnostic immunophenotype report, clinical history (mention if patient is on anti-CD38 therapy), original TRF (Test Requisition Form), date and time when sample was drawn. Anti-coagulation status should be reviewed. No specific fasting is required.
Method: Bone Marrow Aspiration (first pull aspirate)
Laboratory Analysis
Bone marrow aspiration is performed by a qualified physician, typically from the posterior superior iliac crest. The first pull aspirate (3 mL minimum, 1 mL accepted) is collected in 1 Green Top (Sodium Heparin) tube. The sample must be mixed thoroughly immediately after collection. Additionally, 1 or 2 unstained bone marrow aspirate (BMA) smears must be prepared at the source.
Report Delivery
Ship the sample immediately at 18-22°C or at 2-8°C. DO NOT FREEZE the sample. Ensure the sample reaches the laboratory within 72 hours of collection. Room temperature stability: 72 hours. Refrigerator stability: 72 hours. Frozen stability: Not applicable (NA). Label the sample correctly with patient details, date, time, and source information.
Timeline: Report available within 3 working days from sample receipt. Sample collection: Daily by 9 AM.
Patient Instructions
About This Test
Who Should Get This Test
The purpose of the MRD Monitoring test for Multiple Myeloma is to detect and quantify residual malignant plasma cells in the bone marrow at very low levels that are undetectable by conventional morphological or immunohistochemical methods. This test serves several critical purposes: assessing treatment response after induction, consolidation, or maintenance therapy; predicting progression-free survival and overall survival; guiding decisions regarding treatment intensification, de-escalation, or discontinuation; monitoring disease status during long-term follow-up; identifying early molecular relapse before clinical progression; and evaluating the depth of remission to determine eligibility for clinical trials.
How to Prepare
- Collect 3 mL (1 mL minimum) bone marrow aspirate from the first pull to minimize peripheral blood contamination
- Use 1 Green Top (Sodium Heparin) tube for sample collection
- Mix the sample thoroughly immediately after collection to prevent clotting
- Prepare 1 or 2 unstained BMA smears at the source before transporting
- Ship immediately at 18-22°C or at 2-8°C – DO NOT FREEZE
- Provide mandatory clinical information: sample time point, previous immunophenotype report, clinical history (anti-CD38 therapy status), original TRF, date and time of sample draw
- Ensure the sample reaches the laboratory within 72 hours of collection
Doctor's Notes
Reviewed by Dr Pasupathy Arumugam — MBBS, MD (Pathology) · Reg. No. 21521
"MRD monitoring by multiparameter flow cytometry is an indispensable tool in the modern management of multiple myeloma. It allows us to detect residual malignant plasma cells at levels as low as 1 in 100,000 cells, far beyond the sensitivity of conventional morphological examination. Achieving MRD-negative status after treatment is one of the strongest predictors of prolonged progression-free survival. I recommend MRD assessment at defined time points during and after therapy to guide treatment intensification, de-escalation, or maintenance decisions. Patients on anti-CD38 therapies require special consideration in panel design, as CD38 expression on normal plasma cells may be affected by treatment."
Last medically reviewed: September 7, 2026
Test Parameters & Specifications
Sample Stability
- Sample collected in incorrect anticoagulant (not sodium heparin)
- Clotted bone marrow sample
- Sample received frozen or at temperatures outside acceptable range
- Sample volume less than 1 mL
- Sample older than 72 hours from time of collection
- Missing mandatory clinical information (sample time point, immunophenotype report, clinical history, TRF)
- Unlabeled or incorrectly labeled samples
Understanding Your Results
MRD Negative
No aberrant plasma cells detected at the level of test sensitivity (10⁻⁵). This indicates a deep treatment response associated with improved progression-free survival and overall survival. Continue current management as per clinical protocol.
MRD Positive – Low Level
Residual aberrant plasma cells detected at very low levels. May indicate residual disease despite conventional complete response. Close monitoring with repeat MRD testing at defined intervals is recommended. Treatment modification may be considered.
MRD Positive – High Level
Significant residual aberrant plasma cells detected. Suggests inadequate treatment response or early relapse. Urgent clinical review is recommended to consider treatment intensification or change in therapy regimen.
Inconclusive / Insufficient Sample
The sample did not meet quality or cellularity criteria for reliable MRD assessment. Repeat bone marrow aspiration with adequate first-pull sample is recommended. Ensure all mandatory clinical information is provided.
Consult your oncologist or hematologist immediately if: the MRD result is positive, indicating residual disease; there is a change from MRD-negative to MRD-positive status on serial monitoring; clinical symptoms such as bone pain, fatigue, or recurrent infections develop between scheduled test dates; the test result is inconclusive and repeat testing is recommended; or if you are considering any changes to your treatment plan based on MRD results.
Limitations
- ⚠This test assesses MRD in bone marrow aspirate only and may miss focal extramedullary disease or focal bone marrow lesions
- ⚠Sensitivity is limited to approximately 10⁻⁵ (1 myeloma cell per 100,000 nucleated cells); lower levels of disease may not be detected
- ⚠Results are dependent on adequate cellularity and sample quality of the bone marrow aspirate
- ⚠Patients on anti-CD38 monoclonal antibody therapy require modified antibody panels; failure to note this may lead to misinterpretation
- ⚠Clonal heterogeneity within the myeloma population may result in some subclones not being detected by the standard panel
- ⚠False-negative results may occur due to patchy bone marrow involvement or haemodilution
- ⚠This test is not a substitute for comprehensive clinical assessment, imaging, and other laboratory monitoring
Risks & Considerations
- ●Mild to moderate pain at the bone marrow aspiration site
- ●Local bruising or hematoma at the collection site
- ●Rare risk of infection at the aspiration site
- ●Very rare risk of injury to surrounding structures during aspiration
- ●Bleeding, particularly in patients with thrombocytopenia or on anticoagulant therapy
Interfering Factors
- ●Patient currently receiving anti-CD38 therapy (e.g., daratumumab) may interfere with CD38 expression on plasma cells, affecting gating strategy and interpretation
- ●Degraded or improperly stored bone marrow sample may yield unreliable results
- ●Haemodilution of the bone marrow aspirate (non-first pull sample) may reduce sensitivity
- ●Concurrent use of corticosteroids or other immunosuppressive agents may affect plasma cell viability
- ●Recent bone marrow biopsy (within 24 hours) at the same aspiration site may introduce peripheral blood contamination
- ●Sample clotting or inadequate anticoagulation with sodium heparin may compromise cell viability
Compare With Similar Tests
| Test | Minimal Residual Disease (MRD) Monitoring for Multiple Myeloma Test | ||||
|---|---|---|---|---|---|
| Comparison | Minimal Residual Disease (MRD) Monitoring for Multiple Myeloma Test |
Frequently Asked Questions
What is Minimal Residual Disease (MRD) monitoring in multiple myeloma?
Why is MRD monitoring important for multiple myeloma patients?
When should the MRD monitoring test be performed?
What sample is required for the MRD monitoring test?
What is the cost of the MRD monitoring test in India?
How long does it take to get the MRD test results?
What does a negative MRD result mean?
What does a positive MRD result mean?
I am on anti-CD38 therapy (e.g., daratumumab). Does this affect the MRD test?
What is the difference between MRD monitoring and conventional tests for myeloma?
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Is free home sample collection available for the MRD test?
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