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Leukemia/Lymphoma Evaluation
Test CodeLAB44401638
Quest Code
35080
CPT Codes
88184, 88185 (x21), 88189<br>This test is for non-New York patient testing. For New York patient testing use test code 37340
Includes
Initial markers evaluated: CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD11c, CD13, CD19, CD20, CD23, CD33, CD34, CD38, CD56, CD64, CD117, HLA-DR, sKappa, sLambda. CD45 is used for gating.
Additional markers may be performed based on the pathologist review. These markers will be performed at an additional charge (CPT code(s): 88185 for each additional marker).
Additional markers may be performed based on the pathologist review. These markers will be performed at an additional charge (CPT code(s): 88185 for each additional marker).
Preferred Specimen
Peripheral blood: 4 mL collected in a sodium heparin (green-top) tube, ACD-A (yellow-top) tube, or EDTA (lavender-top) tube or
Bone marrow: 3 mL collected in a sodium heparin (green-top) tube, ACD-A (yellow-top) tube,or EDTA (lavender-top) tube or
Tissue or body fluids: Any type is acceptable
Bone marrow: 3 mL collected in a sodium heparin (green-top) tube, ACD-A (yellow-top) tube,or EDTA (lavender-top) tube or
Tissue or body fluids: Any type is acceptable
Minimum Volume
3 mL peripheral blood • 1 mL bone marrow
Other Acceptable Specimens
Bone marrow collected in a Pediatric heparin tube
Instructions
Peripheral blood and bone marrow: The tube must be kept at room temperature and shipped to the lab immediately.
Tissue: Any tissue type is acceptable. Tissue size is dependent upon leukocyte cellularity. (The tissue is disaggregated into single cells so that a minimum of 50,000 cells of interest are harvested.) Ship tissue in a sterile plastic container with RPMI 1640 enriched with FBS (10% FBS RPMI). Absolutely no fixative should be added. Refrigerate and ship immediately.
Body Fluids: Any body fluid is acceptable. Sample size is dependent upon cellularity of the sample. (A minimum of 50,000 cells of interest in total volume of fluid). Place fluid in sterile plastic container. Absolutely no fixative should be added. Refrigerate and ship immediately.
A clinical indication and specimen source are required with each specimen. If possible, submit CBC results with differential or an EDTA tube of peripheral blood.
Do not freeze and do not place in fixative.
Because of the critical nature of these specimens, the laboratory will attempt to process all specimens received, regardless of age of specimen.
Tissue: Any tissue type is acceptable. Tissue size is dependent upon leukocyte cellularity. (The tissue is disaggregated into single cells so that a minimum of 50,000 cells of interest are harvested.) Ship tissue in a sterile plastic container with RPMI 1640 enriched with FBS (10% FBS RPMI). Absolutely no fixative should be added. Refrigerate and ship immediately.
Body Fluids: Any body fluid is acceptable. Sample size is dependent upon cellularity of the sample. (A minimum of 50,000 cells of interest in total volume of fluid). Place fluid in sterile plastic container. Absolutely no fixative should be added. Refrigerate and ship immediately.
A clinical indication and specimen source are required with each specimen. If possible, submit CBC results with differential or an EDTA tube of peripheral blood.
Do not freeze and do not place in fixative.
Because of the critical nature of these specimens, the laboratory will attempt to process all specimens received, regardless of age of specimen.
Transport Temperature
Peripheral blood and bone marrow: Room temperature
Tissue and body fluids: Refrigerate (cold packs)
Tissue and body fluids: Refrigerate (cold packs)
Specimen Stability
Peripheral blood and bone marrow
Room temperature: 72 hours (may extend to 5 days, depending on cell viability)
Refrigerated: Not established
Frozen: Not established
Tissue and body fluids
Room temperature: Not established
Refrigerated: 72 hours
Frozen: Unacceptable
Room temperature: 72 hours (may extend to 5 days, depending on cell viability)
Refrigerated: Not established
Frozen: Not established
Tissue and body fluids
Room temperature: Not established
Refrigerated: 72 hours
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
See Collection Instructions
Methodology
Flow Cytometry (FC)
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: Mon-Sat; Report available: 2 days
Reference Range
See Laboratory Report
Clinical Significance
This panel may be used in the initial evaluation of patients with clinical suspicion of hematologic neoplasms. Immunophenotyping by flow cytometry can aid in the diagnosis and classification of leukemia and lymphoma [1]. Subsequent testing of additional cell surface antigens may be needed to help establish a diagnosis.
Leukemias and lymphomas are heterogenous morphologically and clinically. Identification of cell surface markers (T cell, B cell, progenitor, and myeloid markers) by flow cytometry can help assign a cell lineage to neoplastic cells. Accurate immunotyping aids in the diagnosis, classification, and prognosis of hematologic neoplasm and may inform treatment decisions [1].
This immunotyping panel is designed to expedite the evaluation of patients without provisional diagnosis of a certain type of hematologic neoplasm. The results of this panel must be interpreted with cytological, histological, genetic, and clinical findings to generate accurate diagnosis. Additional cell surface markers not included in this panel may be needed to evaluate certain hematologic malignancies (eg, hairy cell leukemia).
Because non-viable cells lead to non-specific antibody binding, specimens should be processed as early as possible.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
Reference
1. Bain BJ, et al. Leukaemia Diagnosis. 5th ed. John Wiley & Sons;2017:69-134.
Leukemias and lymphomas are heterogenous morphologically and clinically. Identification of cell surface markers (T cell, B cell, progenitor, and myeloid markers) by flow cytometry can help assign a cell lineage to neoplastic cells. Accurate immunotyping aids in the diagnosis, classification, and prognosis of hematologic neoplasm and may inform treatment decisions [1].
This immunotyping panel is designed to expedite the evaluation of patients without provisional diagnosis of a certain type of hematologic neoplasm. The results of this panel must be interpreted with cytological, histological, genetic, and clinical findings to generate accurate diagnosis. Additional cell surface markers not included in this panel may be needed to evaluate certain hematologic malignancies (eg, hairy cell leukemia).
Because non-viable cells lead to non-specific antibody binding, specimens should be processed as early as possible.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
Reference
1. Bain BJ, et al. Leukaemia Diagnosis. 5th ed. John Wiley & Sons;2017:69-134.
Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153
