In this section, we will break down flow cytometry, including how it works, what the sensitivity of the test is, the pros and cons, and typical industry use and availability. 

How It Works

Flow cytometry examines bone marrow samples to identify abnormal myeloma cells by analyzing their size, shape, and unique protein markers on the cell surface.

Sensitivity

This test can detect 1 cancer cell among 10,000 to 100,000 normal cells (10⁻⁴ to 10⁻⁵ sensitivity).

Pros

• Widely available in hospitals and laboratories
• FDA-approved for detecting minimal residual disease (MRD) in multiple myeloma

Cons

• Requires a high-quality bone marrow sample
• May miss very small amounts of remaining disease
• It is not the highest level of detection (other tests can measure more cells at a time)

Industry Use

Flow cytometry tests are commonly used in academic settings and clinical trials to monitor MRD. Notable tests include the EuroFlow Next-Generation Flow (NGF) assay. Pharmaceutical companies frequently collaborate with academic centers to utilize flow cytometry for assessing treatment effectiveness in trials.

Availability

Flow cytometry is less commonly used in community oncology centers compared to academic medical centers or large cancer institutions. This is mainly due to:

• Specialized equipment and expertise: Flow cytometry requires advanced technology and trained specialists to analyze and interpret results, which may not be readily available in smaller or community-based practices.
• Sample handling: Proper collection and processing of high-quality bone marrow samples are essential, which can be more challenging in community settings.
• Cost and accessibility: Community oncology centers may have limited access to FDA-approved flow cytometry assays due to cost and resource constraints.

However, some larger or well-resourced community oncology centers may collaborate with specialized laboratories to perform flow cytometry testing for MRD detection in multiple myeloma. Ask your doctor if flow cytometry is available to you.