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FISH, Chromosome D13S319, Del 13q14.3
Test Code16670
CPT Codes
88271 (x2), 88275
Includes
Note: If results are not possible, the test order may be canceled and replaced with a Cytogenetics Communication.
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 (royal blue-top) tube, or sodium heparin lead-free (tan-top) tube • 5x5mm fresh lymph node collected in Hanks' or Ringer's solution
Instructions
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.
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
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
Set up: Daily; Report available: 5 days
Reference Range
See Laboratory Report
Clinical Significance
This fluorescence in situ hybridization (FISH) assay detects deletions in chromosome 13q14.3 with a probe specific for the D13S319 locus. The results of this test may aid in the prognostic assessment for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).
The most common genetic abnormalities of CLL/SLL are del(13q), del(11q), trisomy 12, and del (17p). At least one of these 4 genetic abnormalities can be detected with FISH in >80% of patients with CLL/SLL [1]. Evaluation of these frequent genetic abnormalities is recommended for the investigation of prognosis [2] and may inform treatment decisions [3]. Del(13q) can be detected with FISH in 55% of patients with CLL/SLL [1]. Del(13q) results in the loss of the DLEU2/miR-15a/16-1 cluster, which has been implicated in the pathogenesis of CLL/SLL [4]. As a sole genetic abnormality, del(13q) is considered a favorable prognostic indicator [3].
A combination of genetic techniques is often involved in identifying genetic abnormalities. FISH testing is complementary to conventional cytogenetic analysis (karyotyping) and can be used to detect common cytogenetic abnormalities. However, because FISH is limited to probing specific chromosomal regions, it does not replace conventional cytogenetic analysis or chromosomal microarray for screening unknown abnormalities.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Dohner H, et al. N Engl J Med. 2000;343(26):1910-1916.
2. Naresh KN, et al. B-cell lymphoid proliferations and lymphomas. 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 June 16, 2023. https://tumourclassification.iarc.who.int
3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Chronic lymphocytic leukemia/small lymphocytic lymphoma. Version 3.2023. Updated June 12, 2023. https://www.nccn.org
4. Klein U, et al. Cancer Cell. 2010;17(1):28-40.
The most common genetic abnormalities of CLL/SLL are del(13q), del(11q), trisomy 12, and del (17p). At least one of these 4 genetic abnormalities can be detected with FISH in >80% of patients with CLL/SLL [1]. Evaluation of these frequent genetic abnormalities is recommended for the investigation of prognosis [2] and may inform treatment decisions [3]. Del(13q) can be detected with FISH in 55% of patients with CLL/SLL [1]. Del(13q) results in the loss of the DLEU2/miR-15a/16-1 cluster, which has been implicated in the pathogenesis of CLL/SLL [4]. As a sole genetic abnormality, del(13q) is considered a favorable prognostic indicator [3].
A combination of genetic techniques is often involved in identifying genetic abnormalities. FISH testing is complementary to conventional cytogenetic analysis (karyotyping) and can be used to detect common cytogenetic abnormalities. However, because FISH is limited to probing specific chromosomal regions, it does not replace conventional cytogenetic analysis or chromosomal microarray for screening unknown abnormalities.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Dohner H, et al. N Engl J Med. 2000;343(26):1910-1916.
2. Naresh KN, et al. B-cell lymphoid proliferations and lymphomas. 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 June 16, 2023. https://tumourclassification.iarc.who.int
3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Chronic lymphocytic leukemia/small lymphocytic lymphoma. Version 3.2023. Updated June 12, 2023. https://www.nccn.org
4. Klein U, et al. Cancer Cell. 2010;17(1):28-40.
