Individual features of currently available techniques to monitor MRD in MM
| . | MFC (≥8-color) . | ASO-PCR . | NGS . | PET/CT . |
|---|---|---|---|---|
| Applicability | ∼100% | 60% to 70% | ∼90% | ∼100%* |
| Reproducibility among centers | High | High | Not reported | Moderate at MRD |
| Availability in individual laboratories around the world | High | Intermediate | Limited | Intermediate |
| Diagnostic sample | Important but not mandatory | Mandatory | Mandatory | Important but not mandatory |
| Time | 2-3 h | ≥5 d (follow-up), 3-4 wk (target identification) | ≥7 d | 2 h |
| Cost per sample† | ∼350 USD | ∼500 USD (follow-up), ∼1500 USD at diagnosis (target identification) | ∼700 USD | ∼2000 USD |
| Sensitivity‡ | 10−5 to 10−6 | 10−5 to 10−6 | 10−6 | High (4 mm) |
| Quantitative | Yes (directly; high accuracy) | Yes | Yes | Yes |
| Fresh sample | Needed (<36 h) | Not needed | Not needed | NA |
| Patchy sample | Impacts | Impacts | Impacts | No impact |
| Global cell characterization | Yes | No | No | No |
| Standardization | Ongoing (EuroFlow/IMF) | Yes, since 15 y (EuroMRD) | Not reported | No |
| . | MFC (≥8-color) . | ASO-PCR . | NGS . | PET/CT . |
|---|---|---|---|---|
| Applicability | ∼100% | 60% to 70% | ∼90% | ∼100%* |
| Reproducibility among centers | High | High | Not reported | Moderate at MRD |
| Availability in individual laboratories around the world | High | Intermediate | Limited | Intermediate |
| Diagnostic sample | Important but not mandatory | Mandatory | Mandatory | Important but not mandatory |
| Time | 2-3 h | ≥5 d (follow-up), 3-4 wk (target identification) | ≥7 d | 2 h |
| Cost per sample† | ∼350 USD | ∼500 USD (follow-up), ∼1500 USD at diagnosis (target identification) | ∼700 USD | ∼2000 USD |
| Sensitivity‡ | 10−5 to 10−6 | 10−5 to 10−6 | 10−6 | High (4 mm) |
| Quantitative | Yes (directly; high accuracy) | Yes | Yes | Yes |
| Fresh sample | Needed (<36 h) | Not needed | Not needed | NA |
| Patchy sample | Impacts | Impacts | Impacts | No impact |
| Global cell characterization | Yes | No | No | No |
| Standardization | Ongoing (EuroFlow/IMF) | Yes, since 15 y (EuroMRD) | Not reported | No |
EuroFlow, see www.EuroFlow.org; EuroMRD, see www.EuroMRD.org; IMF, International Myeloma Foundation; PET/CT, positron emission tomography/computed tomography; USD, US dollars. NA, not appropriate.
Specifically for extramedullary disease.
Costs calculated based on both reagent and personnel costs for a medium-size laboratory receiving ∼150 to 200 MRD samples per year.
Defined as minimal percentage of cells detectable within or out of the quantitative range of the method or in size for imaging techniques.