The Adaptive Experience

The type of specimen used for clonoSEQ MRD testing varies based on the patient’s diagnosis.

What types of samples are used for clonoSEQ testing in the real world?

While bone marrow is generally considered the “standard” sample type for MRD assessment in lymphoid cancers, real-world testing behaviors vary based on the patient’s diagnosis. In myeloma, clinicians widely utilize bone marrow, but data are emerging about the use of blood*.1-2 Increasingly, the use of peripheral blood* samples is being incorporated into clonoSEQ MRD testing in ALL, to monitor patients in between bone marrow draws. In CLL, blood* is the primary sample type submitted for clonoSEQ MRD testing, but bone marrow samples are also used; data from clonoSEQ’s clinical validation studies in CLL supports the prognostic value of testing in both sample types.3

Bone marrow

AdaptiveExp 6 ALL AdaptiveExp 6 MM AdaptiveExp 6 CLL

This page is intended for use by healthcare professionals of the United States.

clonoSEQ® is available as a FDA-cleared in vitro diagnostic (IVD) test service provided by Adaptive Biotechnologies to detect minimal residual disease (MRD) in bone marrow samples from patients with multiple myeloma or B-cell acute lymphoblastic leukemia (B-ALL) , and blood or bone marrow from patients with chronic lymphocytic leukemia (CLL). clonoSEQ is also available for use in other lymphoid cancers as a CLIA-validated laboratory developed test (LDT) service. For important information about the FDA-cleared uses of clonoSEQ including test limitations, please visit

*Blood-based MRD testing for patients with B-Cell acute lymphoblastic leukemia (B-ALL) and multiple myeloma is available as a CLIA-regulated laboratory developed test (LDT) service provided by Adaptive Biotechnologies. This use of clonoSEQ has not been approved or cleared by the FDA


  1. Sanoja-Flores L, Flores-Montero J, Puig N, et al. Blood monitoring of circulating tumor plasma cells by next generation flow in multiple myeloma after therapy. Blood. 2019;134(24):2218-2222. doi:10.1182/blood.2019002610
  2. Vij R, Mazumder A, Klinger M, et al. Deep sequencing reveals myeloma cells in peripheral blood in majority of multiple myeloma patients. Clin Lymphoma Myeloma Leuk. 2014;14(2):131-139.e1. doi:10.1016/j.clml.2013.09.013
  3. clonoSEQ®. [technical summary]. Seattle, WA: Adaptive Biotechnologies; 2020.