Laboratory:
Cytogenetics
Referral Laboratory:
MiChart Code:
Cytogenetics, CLL FISH Panel
Soft Order Code:
CGCLL
Synonyms:
Locus Anomalies, CLL, FISH Chronic Lymphocytic Leukemia (CLL), FISH panel
CLL FISH FISH for Chronic Lymphocytic Leukemia (CLL)
Container:
Green top (sodium heparin) tube
Normal Volume:
5 mL whole blood (with >10% involvement) or 2 mL bone marrow
Minimum Volume:
2 mL whole blood (with >10% involvement) or 1 mL bone marrow
Offsite Collection:
Specimen transport should be arranged so that the specimen is received by MLabs the same day it is collected. Call for a STAT courier if necessary. Collect specimen in a green top (sodium heparin) tube. Invert the tube several times to prevent clotting. Send at room temperature as soon as possible. Do not allow specimen to overheat or freeze. Clotted samples or those that are greater than 24 hours old are suboptimal. CLL FISH panel testing may be performed as a "stand alone" test or included with Chromosome Analysis, Bone Marrow testing.
Onsite Collection (Michigan Medicine Hospitals Only):
Collect specimen in a sterile syringe rinsed with sodium heparin or a green top Vacutainer® (sodium heparin) tube. Invert several times to prevent clotting. Send at room temperature as soon as possible. Do not allow specimen to overheat or freeze. Please complete a MiChart test request and submit it with the specimen. A Cytogenetics Laboratory Requisition is available online at: http://www.pathology.med.umich.edu/handbook/Tables/UM_REQ_CYTOGENETICS.pdf. CLL FISH panel testing may be performed as a "stand alone" test or included with Chromosome Analysis, Bone Marrow testing.
Days Set Up:
Monday - Friday, 8:00am - 4:00pm
Reference Range:
*Reference ranges may change over time. Please refer to the original patient report when evaluating results.
Interpretive report provided.
Test Usage:
The CLL FISH panel is used to ascertain common recurrent genetic abnormalities that have known prognostic significance in CLL when detected by interphase FISH analysis. Use at the time of diagnosis of CLL for prognostic information and to differentiate from mantle cell lymphoma associated with the t(11;14), and, at progression or relapse to detect clonal evolution. The panel includes tests for the following chromosome abnormalities using probes for the specific gene locus (in italics); deletion of 13q at 13q14.3, del(13q), (D13S319); trisomy 12, +12, (D12Z3); deletion of 11q at 11q22.3, del(11q), (ATM); deletion of 17p at 17p13.1, del(17p), (TP53); and translocation of 11q13 and 14q32, t(11;14)(q13;q32), (IGH/CCND1). Note: while other hematologic malignancies frequently carry similar genetic abnormalities, the prognostic significance may differ significantly from that found for CLL. Also, this test cannot discern for all loci tested whether the clonal abnormalities detected are present in the same clonal population or whether independent clonal proliferations are present. Thus, if myelodysplastic syndrome is suspected a bone marrow sample should be sent for standard cytogenetic analysis.
Test Methodology:
Interphase Fluorescence In Situ Hybridization (FISH)
Additional Information:
"Stand alone" FISH testing will include Tissue Culture at an additional charge.
CPT Code:
88237, 88275 x3, 88271
Fee Code:
36542, EA041 x3, EA040
Rejection Criteria:
Clotted or hemolyzed specimen, specimen over 24 hours old, or those from septic or transfused patients.
Test ID:
172