Comparison of different bone marrow MRD techniques
| Characteristic . | Flow cytometry . | Immunoglobulin NGS . |
|---|---|---|
| Applicability | Nearly 100% | ≥90% |
| Diagnostic sample | Ideally, sample with myeloma present, although abnormal plasma cells can be identified in any sample by their distinct immunophenotypic pattern vs normal plasma cells | Sample with myeloma present (e.g., presentation) required for identification of the dominant clonotype |
| Sample requirements | 2-5 million cells | 1 million cells |
| Sample processing | Requires fresh sample; assessed within 24-48 h | Can use both fresh and stored samples |
| Standardization | Methodology varies between laboratories. Some attempts at standardization (e.g., EuroFlow) | Standardized methodology available from commercial companies. Academic methodologies also available |
| Quantitative | Yes | Yes |
| Sensitivity | 1 in 104 to 1 in 106 | 1 in 105 to 1 in 106 |
| Turnaround and complexity | Hours. Requires skilled flow cytometrist. Automated software available | 1 wk. Bioinformatic analysis available |
| Clonal evolution | Considers all clones with similar phenotype but evolving clone with change in phenotype may not be evaluable | Can take into account all minor clones with infrequent occurrence |
| Availability | Many laboratories with 4 color; 8 or more colors restricted to more specialized centers | One company commercially and a number of academic platforms |
| Characteristic . | Flow cytometry . | Immunoglobulin NGS . |
|---|---|---|
| Applicability | Nearly 100% | ≥90% |
| Diagnostic sample | Ideally, sample with myeloma present, although abnormal plasma cells can be identified in any sample by their distinct immunophenotypic pattern vs normal plasma cells | Sample with myeloma present (e.g., presentation) required for identification of the dominant clonotype |
| Sample requirements | 2-5 million cells | 1 million cells |
| Sample processing | Requires fresh sample; assessed within 24-48 h | Can use both fresh and stored samples |
| Standardization | Methodology varies between laboratories. Some attempts at standardization (e.g., EuroFlow) | Standardized methodology available from commercial companies. Academic methodologies also available |
| Quantitative | Yes | Yes |
| Sensitivity | 1 in 104 to 1 in 106 | 1 in 105 to 1 in 106 |
| Turnaround and complexity | Hours. Requires skilled flow cytometrist. Automated software available | 1 wk. Bioinformatic analysis available |
| Clonal evolution | Considers all clones with similar phenotype but evolving clone with change in phenotype may not be evaluable | Can take into account all minor clones with infrequent occurrence |
| Availability | Many laboratories with 4 color; 8 or more colors restricted to more specialized centers | One company commercially and a number of academic platforms |