Acute Myeloid Leukemia Prognostic Panel (Normal Karyotype)

Test Code
AMLPNL


Quest Code
90871


CPT Codes
81218, 81310, 81245, 81246

Includes
CEBPA Mutation Analysis
NPM (Exon 12) Mutation Analysis, Cell-based
FLT3 Mutation Assay


Preferred Specimen
5 mL whole blood collected in an EDTA (lavender-top) tube


Minimum Volume
Whole blood: 3 mL • Bone marrow: 1 mL • Tissue: 2x3 mm


Other Acceptable Specimens
3 mL bone marrow collected in an EDTA (lavender-top) tube • Cell pellet collected in a sterile transport tube • 5x5 mm tissue collected in a paraffin block


Instructions
Do not reject. Send to lab for evaluation.

Whole blood (preferred): Follow standard whole blood collection procedure. Collect 3-5 mL whole blood samples in an EDTA tube. Blood samples are shipped at room temperature or 4° C. Do not freeze whole blood. Record the draw time and date on the tube. Ship immediately to maintain sample stability.

Cell pellet: This assay  is also designed for the remnant cell pellet from Cytogenetics. The cell pellet usually fixed should be transported refrigerated to the laboratory as soon as possible. Please provide a copy of the Cytogenetics report.


Transport Temperature
Refrigerated


Specimen Stability
Whole blood and bone marrow
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Unacceptable

Cell pellet
Room temperature: Unacceptable
Refrigerated: 30 days
Frozen: 30 days

Tissue
Room temperature: Preferred
Refrigerated: Acceptable
Frozen: Unacceptable


Methodology
See individual tests

FDA Status
CEBPA Mutation Analysis and NPM (Exon 12) Mutation Analysis, Cell-based: This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule
See individual assays


Reference Range
See Laboratory Report


Clinical Significance
This testing, consisting of FLT3, NPM-1, and CEBPA, is recommended in the NCCN guidelines for determination of AML risk status in patients with cytogenetically normal AML. The presence of CEBPA gene mutations is associated with increased disease-free survival and overall survival. Mutations in NPM1 gene is a predictor of favorable prognosis and good response to induction chemotherapy. The presence of (FLT3) internal tandem duplication is associated with short disease-free survival.


Performing Laboratory
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042



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.