Test Code CLLMF Chronic Lymphocytic Leukemia, Specified FISH, Varies
Ordering Guidance
This test is intended for instances when limited chronic lymphocytic leukemia (CLL) fluorescence in situ hybridization (FISH) probes are needed based on specific abnormalities or abnormalities identified in the diagnostic sample.
If targeted FISH probes are not included with this test order, test processing will be delayed and the test may be canceled and automatically reordered by the laboratory as CLLDF / Chronic Lymphocytic Leukemia, Diagnostic FISH, Varies.
If a paraffin-embedded tissue sample is received, this test will be canceled and automatically reordered by the laboratory as SLL / Small Lymphocytic Lymphoma, FISH, Tissue.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
A reason for testing and a flow cytometry and/or a bone marrow pathology report should be submitted with each specimen. The laboratory will not reject testing if this information is not provided; however, appropriate testing and/or interpretation may be compromised or delayed in some instances. If not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
Specimen Required
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Blood
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood in original tube. Do not aliquot.
Acceptable:
Specimen Type: Bone marrow
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 2 to 3 mL
Collection Instructions:
1. It is preferable to send the first aspirate from the bone marrow collection.
2. Invert several times to mix bone marrow.
3. Send bone marrow in original tube. Do not aliquot.
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Useful For
Detecting recurrent common chromosome abnormalities in patients with chronic lymphocytic leukemia (CLL)
Distinguishing patients with 11;14 translocations who have the leukemic phase of mantle cell lymphoma from patients who have CLL
Detecting patients with atypical CLL with translocations between IGH and BCL3
Evaluating specimens in which chromosome studies are unsuccessful
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
CLLMB | Probe, Each Additional (CLLMF) | No, (Bill Only) | No |
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
CLL, Specified FISHSpecimen Type
VariesSpecimen Minimum Volume
Blood: 2 mL; Bone marrow: 1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Ambient (preferred) | ||
Refrigerated |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Chronic lymphocytic leukemia (CLL) is one of the most common leukemias in adults. The most frequently seen cytogenetic abnormalities in CLL involve chromosomes 6, 11, 12, 13, and 17. These are detected and quantified using the CLL fluorescence in situ hybridization (FISH) panel.
Use of CpG-oligonucleotide mitogen will identify an abnormal CLL karyotype in at least 80% of cases. This mitogen is added to cultures when chromosome analysis is ordered and the reason for testing is B-cell lymphoproliferative disorders (CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow and CHRHB / Chromosome Analysis, Hematologic Disorders, Blood).
This FISH test detects an abnormal clone in approximately 70% of patients with indolent disease and greater than 80% of patients who require treatment. At least 5% of patients referred for CLL FISH testing have translocations involving the IGH locus. Fusion of IGH with CCND1 is associated with t(11;14)(q13;q32), and fusion of IGH with BCL3 is associated with t(14;19)(q32;q13.3). Patients with t(11;14) usually have the leukemic phase of mantle cell lymphoma. Patients with t(14;19) may have an atypical form of B-CLL or the leukemic phase of a lymphoma. The prognostic associations for chromosome abnormalities detected by this FISH assay are, from best to worst: 13q-, normal, +12, 6q-, 11q-, and 17p-.
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88271x2, 88275, 88291-FISH Probe, Analysis, Interpretation; 1 probe set
88271x2, 88275-FISH Probe, Analysis; each additional probe set (if appropriate)