Bone marrow hemodilution assessment in multiple myeloma MRD by next generation flow cytometry - a mini review
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By
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May 1, 2026
Objective:
To review the impact of bone marrow hemodilution on measurable residual disease (MRD) assessment in multiple myeloma, highlighting its clinical significance and implications for treatment strategies, using next generation flow cytometry (NGF).
Key Findings:
- Hemodilution can lead to false negative MRD assessments in multiple myeloma, particularly in low burden cases.
- Mast cells (MC) are the most effective standalone indicator of hemodilution, but a combined evaluation with NRBC and BCP is more reliable, especially in the context of treatment effects.
- Treatment can significantly influence the representation of cellular populations, complicating hemodilution assessments and potentially leading to misleading clinical outcomes.
Interpretation:
The review underscores the need for standardized approaches to assess and report hemodilution in MRD evaluations, as current methodologies vary and can lead to inconsistent results, ultimately affecting patient management.
Limitations:
- Lack of standardized approaches for estimating and interpreting hemodilution, which complicates clinical decision-making.
- Variability in methodologies and reference indices across different studies, impacting the comparability of research findings.
Conclusion:
Standardization in assessing hemodilution is crucial for accurate MRD evaluation in multiple myeloma, as current practices may lead to misleading clinical outcomes and affect treatment strategies.
