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FISH, AML Targeted Panel
Test Code13730
CPT Codes
88271 (x12), 88275 (x6)
Includes
If results are not possible from the submitted specimen, the test order will be cancelled and replaced by non-orderable test Cytogenetics Communication.
Note: STAT handling for PML-RARA component is available only by request. Please include a note STAT for PML-RARA, MD contact name, and phone number to receive preliminary STAT results.
Note: STAT handling for PML-RARA component is available only by request. Please include a note STAT for PML-RARA, MD contact name, and phone number to receive preliminary STAT results.
Preferred Specimen
5 mL whole blood or 3 mL bone marrow collected in a sodium heparin (green-top) tube
Minimum Volume
3 mL whole blood • 1 mL bone marrow
Other Acceptable Specimens
EDTA (lavender-top) tube
Instructions
Clinical history and reason for referral are required with test order. Prior therapy and bone marrow 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.
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: Preferred
Refrigerated: Acceptable
Frozen: Unacceptable
Refrigerated: Acceptable
Frozen: Unacceptable
Methodology
Fluorescence in situ Hybridization (FISH)
Setup Schedule
Set up: Daily; Report available: 7 days
Reference Range
See Laboratory Report
Clinical Significance
As per current WHO specifications, all probes listed above are of prognostic value in a newly diagnosed case of AML. Additionally, rearrangements of CBFB/MYH11, RUNX1T1/RUNX1 and PML/RARA are diagnostic of AML. There are other recurrent cytogenetic abnormalities included in the WHO category, however only more specific abnormalities are included in the AML panel.
Typically, conventional cytogenetics is the gold standard for the identification of the recurrent chromosome abnormalities in AML. However, some of the more subtle rearrangements are below the resolution and can be missed by this method, such as KMT2A rearrangements and TP53 deletions. Additionally, cytogenetic studies require setting up 24-hour and 48-hour cell cultures before analysis can be performed. Fluorescence In-Situ Hybridization (FISH) is a molecular cytogenetic technique used in the identification of microdeletions, aneuploidies, marker chromosomes, and translocations on either metaphase cells or interphase nuclei from patient samples with acquired abnormalities (e.g. hematologic disorders). Given the medical necessity of rapid diagnosis of an acute leukemia case, FISH analysis can be performed on a direct harvest of cells from the specimen and results are typically available in less than 24 hours. Therefore, running a rapid AML panel targeting most noted abnormalities aids in timely diagnosis of acute leukemia cases.
Typically, conventional cytogenetics is the gold standard for the identification of the recurrent chromosome abnormalities in AML. However, some of the more subtle rearrangements are below the resolution and can be missed by this method, such as KMT2A rearrangements and TP53 deletions. Additionally, cytogenetic studies require setting up 24-hour and 48-hour cell cultures before analysis can be performed. Fluorescence In-Situ Hybridization (FISH) is a molecular cytogenetic technique used in the identification of microdeletions, aneuploidies, marker chromosomes, and translocations on either metaphase cells or interphase nuclei from patient samples with acquired abnormalities (e.g. hematologic disorders). Given the medical necessity of rapid diagnosis of an acute leukemia case, FISH analysis can be performed on a direct harvest of cells from the specimen and results are typically available in less than 24 hours. Therefore, running a rapid AML panel targeting most noted abnormalities aids in timely diagnosis of acute leukemia cases.
