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Test ID MFCDF Myeloma, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Fixed Cell Pellet


Ordering Guidance


For the most complete genetic evaluation on fresh bone marrow specimens, order MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow.

For evaluation of high-risk abnormalities plus CCND1/IGH fusion on fresh bone marrow specimens, order PCPDS / Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow.

 

For testing paraffin-embedded tissue samples from patients with a plasma cell disorder, order PLASF / Plasma Cell Proliferative Disorder, FISH, Tissue.

 

Testing will be changed to the appropriate test if this test is ordered on paraffin or a fresh bone marrow specimen.



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 sent with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.



Specimen Required


Container/Tube: Sterile container

Specimen Volume: 1 Fixed cell pellet

Collection Instructions: Place specimen in a sterile container with a 3:1 methanol:glacial acetic acid (or similar) fixative.


Useful For

Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders using a fixed cell pellet derived from bone marrow

 

Identifying prognostic markers based on the abnormalities found

 

This test should not be used to track the progression of disease.

Testing Algorithm

This test includes a charge for the probe application, analysis, and professional interpretation of results for 3 probe sets (6 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.

 

This test is designed for diagnostic bone marrow specimens from patients with multiple myeloma or other plasma cell proliferative disorders. Best results are obtained when the bone marrow demonstrates at least 20% involvement by a plasma cell proliferative disorder.

 

The FISH panel includes testing for the following abnormalities using the FISH probes listed:

 

For diagnostic samples, the following probes will be evaluated:

17p-, TP53/D17Z1

1q gain, TP73/1q22

14q32 rearrangement, IGH break-apart

Based on the results from the initial panel, reflex testing may be performed to identify the following abnormalities using the probes listed:

t(11;14)(q13;q32), CCND1/IGH fusion

t(14;16)(q32;q23), IGH/MAF fusion

t(4;14)(p16.3;q32), FGFR3/IGH fusion

t(14;20)(q32;q12), IGH/MAFB fusion 

 

For follow-up samples, the following probes will be evaluated if sufficient plasma cells are identified:

If a previous diagnostic sample was uninformative for a probe set, attempts may be made to achieve results for the missing probe on a subsequent sample.

17p-, TP53/D17Z1

1q gain, TP73/1q22

8q24.1 rearrangement, MYC break-apart

 

Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

Myeloma Fixed Cell, High Risk, FISH

Specimen Type

Fixed Cell Pellet Bone Marrow

Specimen Stability Information

Specimen Type Temperature Time Special Container
Fixed Cell Pellet Bone Marrow Ambient (preferred)
  Refrigerated 

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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.

CPT Code Information

88271x6, 88275x3, 88291 x1-FISH Probe, Analysis, Interpretation; 3 probe sets

88271x2, 88275x1-FISH Probe, Analysis; each additional probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MFCDF Myeloma Fixed Cell, High Risk, FISH In Process

 

Result ID Test Result Name Result LOINC Value
614300 Result Summary 50397-9
614301 Interpretation 69965-2
614302 Result Table 93356-4
614303 Result 62356-1
GC128 Reason for Referral 42349-1
614304 Specimen 31208-2
614305 Source 31208-2
614306 Method 85069-3
614307 Additional Information 48767-8
614308 Disclaimer 62364-5
614309 Released By 18771-6

NY State Approved

Yes

Forms

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