Table 1.

Comparison of MRD assessments by BM vs PB MS

BM aspirate for MRDPB for MS MRD
Advantages Well established, standardized, and validated Not invasive
Patient preference
Allows for more frequent and dynamic monitoring 
Disadvantages Invasive, limited by patient tolerability
Hemodilution may affect sensitivity
Cannot assess for extramedullary disease
Limited by patchy BM involvement 
Half-life of IgG (∼23 days) and IgA (4-7 days) may lead to false “positive” MRD assessment; half-life even longer with smaller concentrations
Not useful in nonsecretory disease
For clonotypic MS, requires a baseline sample to enable tracking 
BM aspirate for MRDPB for MS MRD
Advantages Well established, standardized, and validated Not invasive
Patient preference
Allows for more frequent and dynamic monitoring 
Disadvantages Invasive, limited by patient tolerability
Hemodilution may affect sensitivity
Cannot assess for extramedullary disease
Limited by patchy BM involvement 
Half-life of IgG (∼23 days) and IgA (4-7 days) may lead to false “positive” MRD assessment; half-life even longer with smaller concentrations
Not useful in nonsecretory disease
For clonotypic MS, requires a baseline sample to enable tracking 

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