Effective May 1st, 2026, the Cancer Genetics and Genomics Laboratory (CGL) at BC Cancer will be accepting bone marrow specimens collected from newly diagnosed multiple myeloma patients who may be transplant eligible (ND-TEMM), facilitating the on-label use of daratumumab (Darzalex™) as part of quadruplet-based therapy in this patient cohort. Collection of bone marrow specimens at diagnosis allows for the identification of the plasma cell immunoglobulin clonotype (IgH VDJ or IgK VJ) post-transplant. Identification of this clonotype is required for later measurable residual disease (MRD) assessments. MRD assessment will be performed one- and two-years post-transplant on patients in a suspected complete response (CR) or those in very good partial response (VGPR) where the persistent monoclonal protein is thought to be related to detection of daratumumab, with the aim of discontinuing daratumumab in patients found to be MRD negative. More information is available on the Multiple Myeloma webpage.
The clonotype will be determined using the Invivoscribe Lymphotrack™ NGS solution (pending completion of test validation at CGL by the end of Q3 2026).
The current funding approval covers clonotype identification (and later MRD assessment) of newly diagnosed multiple myeloma patients potentially eligible for stem cell transplantation or where this is not yet determined. Initially, testing of stored genomic DNA will be performed only on those patients that have undergone an auto-transplant.
Note: Although testing has been requested, testing will only be initiated upon completion of test validation at CGL and notification to CGL that the patient has undergone an auto-transplant and meets above serologic response criteria.
Testing can be ordered using either the CGL Lymphoid Requisition or CGL Myeloid Requisition available on our Requisitions page. In addition to current standard of care tests for newly diagnosed multiple myeloma patients, CGL requires an additional 2mL aspirated bone marrow (purple top (EDTA) vacutainer). Refer to the memo for additional information on the necessary specimens required.