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Test ID CHRGB Chimerism-Recipient Germline (Pretransplant), Varies

Useful For

Evaluating the recipient cells prior to bone marrow transplant

Method Name

Polymerase Chain Reaction (PCR) Amplification/Capillary Electrophoresis

Reporting Name

Chimerism-Recipient Germline

Specimen Type

Varies


Ordering Guidance


This test is for the pre-bone marrow transplant evaluation of the recipient specimen.



Additional Testing Requirements


 



Shipping Instructions


1. Specimen must arrive within 7 days of collection.

2. Collect and package specimen as close to shipping time as possible.



Necessary Information


The following information is required. Provide either as answers to the Order Questions or on Chimerism Analysis Information (T594) if not ordering electronically. Testing will be delayed if this information is not provided:

Donor:

-Full name and date of birth (DOB)

-If unrelated donor, provide full identification number and date of birth (DOB). If DOB is not provided, an arbitrary date such as 01/01/2020 can be used.

Specimen type



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Whole blood

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 4 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Label specimen as blood.

3. Send whole blood specimen in original tube. Do not aliquot.

 

Specimen Type: Bone marrow

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Label specimen as bone marrow.

3. Send bone marrow specimen in original tube. Do not aliquot.

 

Specimen Type: Extracted DNA from blood or bone marrow

Container/Tube: 1.5- to 2-mL tube

Specimen Volume: Entire specimen

Collection Instructions:

1. Label specimen as extracted DNA from blood or bone marrow

2. Indicate volume and concentration of the DNA

 

Specimen Type: Buccal swab

Supplies: Buccal Swab Kit (T543)

Container/Tube: Buccal smear collection kit

Specimen Volume: 2 Cyto-Pak brushes-1 per cheek

Collection Instructions:

1. Patient should rinse out mouth vigorously with mouthwash for approximately 15 seconds.

2. Remove Cyto-Pak brush from container only touching "stick" end. Save container.

3. Using medium pressure, rotate brush several times on inside of cheek.

4. Return brush to container and cap.

5. Repeat steps 2 through 4 on other cheek using second brush.

6. It is important that patient's buccal cells are not contaminated with cells from any other source. Do not touch bristles. Do not brush too vigorously. If blood appears, discard brush and restart collection process.

7. Label each container with patient's name and order number or hospital/clinic number.

Additional Information: It is important that the cells do not dry out during shipping. Ensure that container is tightly sealed.


Specimen Minimum Volume

Whole blood: 3 mL
Bone marrow/buccal swab: See Specimen Required
Extracted DNA from blood or bone marrow: 50 microliters at 20 ng/microliter
Lesser volumes may be acceptable, depending on white cell count.
Call 800-533-1710 or 507-266-5700 with questions.

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred) 7 days
  Refrigerated  7 days

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

81265-Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin zygosity testing or maternal cell contamination of fetal cells)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CHRGB Chimerism-Recipient Germline 31208-2

 

Result ID Test Result Name Result LOINC Value
MP007 Donor 44780-5
MP014 Specimen Type 31208-2
83186 Chimerism-Recipient Germline No LOINC Needed

Test 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.

Testing Algorithm

Complete chimerism analysis requires 3 specimens, under 3 separate orders, for the 3 separate tests listed below. These specimens should be submitted when collected. An interpretive report will be provided once all specimens are received.

 

Pretransplant:

-CHRGB / Chimerism-Recipient Germline (Pretransplant), Varies

-CHIDB / Chimerism-Donor, Varies

-ADONO / Additional Chimerism Donor (Bill Only), if applicable

 

Posttransplant:

-CHIMU / Chimerism Transplant No Cell Sort, Varies or CHIMS / Chimerism Transplant Sorted Cells, Varies

 

Billing occurs with the following tests:

Pretransplant:

-CHRGB / Chimerism-Recipient Germline (Pretransplant), Varies

-ADONO / Additional Chimerism Donor (Bill Only), if applicable

 

Posttransplant:

-CHIMU / Chimerism Transplant No Cell Sort, Varies

-CHIMS / Chimerism Transplant Sorted Cells, Varies

-SORT1 / Chimerism Cell Sort 1 (Bill Only)

-SORT2 / Chimerism Cell Sort 2 (Bill Only)

 

For more information see Chimerism-Recipient Germline Testing Algorithm

Report Available

4 to 8 days

NY State Approved

Yes

Forms

1. Chimerism Analysis Information Sheet (T594)

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726)) with the specimen.