CXCR4 Mutation Analysis

Message
Bi-directional sequencing to detect nonsense, frameshift, and other mutations encoding the C-terminus of CXCR4. Analyzed range includes detection of the C1013G mutation and spans amino acids L301 to S352.


Test Code
LAB6304


Alias/See Also
CXCR4


CPT Codes
81479x1

Preferred Specimen
Peripheral blood: 5 mL in EDTA tube. Bone marrow: 2 mL in EDTA tube. FFPE tissue: Paraffin block is preferred. Alternatively, send 1 H&E slide plus 5-10 unstained slides cut at 5 or more microns. Please use positively-charged slides and 10% NBF fixative. Do not use zinc fixatives.


Instructions
Use cold pack for transport. Make sure cold pack is not in direct contact with specimen.


Methodology
Molecular

Report Available
10 days


Clinical Significance
CXCR4 activates AKT1/MAPK pathways in B-lineage cells and facilitates cell migration in Waldenstrom macroglobulinemia (WM). Mutations are detected in nearly 30% of WM cases, and are associated with primary resistance and initial lack of response to BTK, PI3K, and mTOR inhibitors. The majority of these cases with CXCR4 mutations have concurrent MYD88 L265P mutations. The common C1013G mutation in CXCR4 and other somatic frameshift and nonsense mutations detected by this test are the same as or similar to the germline mutations associated with WHIM syndrome. Therapeutic antagonists to CXCR4 are in clinical trials.


Performing Laboratory
Neogenomics Laboratories



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.