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FISH, ETV6/RUNX1 (TEL/AML1), Translocation (12;21)
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Test Code
TELAML
Alias/See Also
14618
CPT Codes
88271 (x2), 88275
Preferred Specimen
5 mL whole blood or 3 mL bone marrow collected in a sodium heparin (green-top) tube
Minimum Volume
1 mL
Other Acceptable Specimens
Sodium heparin (royal blue-top) tube • Sodium heparin lead-free (tan-top) tube
Instructions
Bone marrow 1-3 mL or whole blood 3-5 mL collected in a sodium heparin tube.
Transport Temperature
Room temperature
Specimen Stability
Specimen viability decreases during transit. Send specimen to testing lab for viability determination. Do not freeze. Do not reject.
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 FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Set up: Daily; Report available: 5-7 days
Clinical Significance
This fluorescence in situ hybridization (FISH) assay detects the ETV6/RUNX1 (TEL/AML1) fusion gene and is used for determining prognosis of patients with acute lymphoblastic leukemia (ALL) and monitoring for recurrence.
The ETV6/RUNX1 (TEL/AML1) fusion gene results from the t(12;21)(p13;q22) translocation and is usually undetectable by conventional chromosome analysis [1]. Although it occurs rarely in adults, it is the most common recurrent translocation in B-lineage pediatric ALL (frequency ~25%) [2]. The presence of the ETV6/RUNX1 (TEL/AML1) fusion gene is indicative of ALL with a favorable prognosis partially due to chemosensitivity, especially in patients <10 years of age [2]. Relapses of ALL with ETV6/RUNX1(TEL/AML1) generally occur later than ALL with other recurrent genetic abnormalities and have a significant likelihood of being successfully treated [2]. Therefore, evaluation of this and other recurrent genetic abnormalities aids in risk stratification, treatment decisions, and monitoring disease status.
Interpretation of the test results depends on when the test is performed. The presence of the ETV6/RUNX1 (TEL/AML1) fusion gene at diagnosis is indicative of ALL with a favorable prognosis. In patients who are currently being treated or have just completed the treatment regimen, presence of the ETV6/RUNX1 (TEL/AML1) fusion gene indicates residual disease. In patients thought to be in remission, presence of the ETV6/RUNX1 (TEL/AML1) fusion gene indicates recurrent disease.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Acute lymphoblastic leukemia. Version 2.2023. Updated July 28, 2023. https://www.nccn.org
2. Kovach AE, et al. B lymphoblastic leukaemia/lymphoma with ETV6::RUNX1 fusion. In: WHO Classification of Tumours Editorial Board. The World Health Organization Classification of Haematolymphoid Tumours. 5 Beta V2 ed. IARC Press; 2022:chap 4. Accessed May 23, 2023. https://tumourclassification.iarc.who.int
The ETV6/RUNX1 (TEL/AML1) fusion gene results from the t(12;21)(p13;q22) translocation and is usually undetectable by conventional chromosome analysis [1]. Although it occurs rarely in adults, it is the most common recurrent translocation in B-lineage pediatric ALL (frequency ~25%) [2]. The presence of the ETV6/RUNX1 (TEL/AML1) fusion gene is indicative of ALL with a favorable prognosis partially due to chemosensitivity, especially in patients <10 years of age [2]. Relapses of ALL with ETV6/RUNX1(TEL/AML1) generally occur later than ALL with other recurrent genetic abnormalities and have a significant likelihood of being successfully treated [2]. Therefore, evaluation of this and other recurrent genetic abnormalities aids in risk stratification, treatment decisions, and monitoring disease status.
Interpretation of the test results depends on when the test is performed. The presence of the ETV6/RUNX1 (TEL/AML1) fusion gene at diagnosis is indicative of ALL with a favorable prognosis. In patients who are currently being treated or have just completed the treatment regimen, presence of the ETV6/RUNX1 (TEL/AML1) fusion gene indicates residual disease. In patients thought to be in remission, presence of the ETV6/RUNX1 (TEL/AML1) fusion gene indicates recurrent disease.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Acute lymphoblastic leukemia. Version 2.2023. Updated July 28, 2023. https://www.nccn.org
2. Kovach AE, et al. B lymphoblastic leukaemia/lymphoma with ETV6::RUNX1 fusion. In: WHO Classification of Tumours Editorial Board. The World Health Organization Classification of Haematolymphoid Tumours. 5 Beta V2 ed. IARC Press; 2022:chap 4. Accessed May 23, 2023. https://tumourclassification.iarc.who.int
Performing Laboratory
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130
