FISH, Ph-Like ALL Panel

Test Code

39035

CPT Codes
88271 (x6), 88275 (x3)

Preferred Specimen

3 mL bone marrow or 5 mL whole blood collected in a sodium heparin (green-top) tube

Minimum Volume

1 mL bone marrow • 3 mL whole blood

Other Acceptable Specimens

Bone marrow or whole blood collected in sodium heparin (dark/royal blue-top) tube, or sodium heparin lead-free (tan-top) tube • Bone marrow collected in transport medium

Instructions

Bone marrow transport medium is available upon request.
Clinical history/reason for referral is required with test order. Prior therapy and transplant history should be provided with test order.
Specimen viability decreases during transit. Send specimen to testing lab for viability determination. Do not freeze. Do not Reject.

Transport Temperature

Room temperature

Specimen Stability

Room temperature: See instructions
Refrigerated: See instructions
Frozen: See instructions

Methodology
Fluorescence in situ Hybridization (FISH)

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Monday-Sunday Morning Report available: 7 Days

Reference Range

See Laboratory Report

Clinical Significance

Philadelphia chromosome (Ph)-like acute lymphoblastic leukemia (ALL), also referred to as a BCR-ABL1-like ALL, is a high-risk subset with a gene expression profile that shares significant overlap with that of Ph-positive (Ph+) ALL and is suggestive of active kinase signaling. It exhibits adverse clinical features, confers poor prognosis and harbors a diverse range of genetic alterations that active cytokine receptors genes and kinase signaling pathways making it amenable to treatment with tyrosine kinase inhibitor (TKI) therapy. This FISH panel has been designed to detect ABL1, ABL2 and PDGFRB rearrangements associated with the BCR-ABL1-like B-ALL (or Ph-like B-ALL) with ABL class fusions. Diagnosis of BCR-ABL1-like B-ALL patients with ABL1, ABL2 and PDGFRB rearrangements, will enable incorporation of TKI much earlier in the course of treatment as well as selection of patients eligible for future therapy trials.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.