• P18
• 5/9/15
• TP53
• IGH with reflex to:
  •   CCND1/IGH
  •   IGH/MAF
  •   IGH/MAFB
  •   CCND3/IGH
  •   FGFR3/IGH

Detecting abnormalities of plasma cell dyscrasias, including Plasma Cell Myeloma and to provide myeloma cytogenetic risk stratification information for mSMART 3.0.

Dk green Sodium heparin (Na hep), no gel - 4mL

Immediately following collection, mix sample thoroughly by gently inverting 8 - 10 times, to prevent clotting

Dk green Sodium heparin (Na hep), no gel

EDTA whole blood:

Lavender (EDTA), 4mL

Bone marrow

Collect bone marrow aspirate in a sterile Sodium heparin (Na hep) syringe and transfer to a sterile vial/tube

- or -

Collect bone marrow in sterile syringe (non-heparinized) and transfer to a Dk green Sodium heparin (Na hep), no gel

• Only one specimen tube is required to perform all ordered cytogenetics testing.
• The more testing requested, the closer to the optimal volume requirements is required.

EDTA whole blood:

Lavender (EDTA), 4mL

Bone marrow:

Sterile vial/tube

Dk green Sodium heparin (Na hep), no gel

• AHL Cytogenetics oncology request

Ambient

• Improper label (unlabeled or mislabeled)
• Wrong container (anticoagulant or solution)
• Improper blood/anticoagulant ratio
• Delay in transport
• Improper storage
• Leaking container

Fluorescence in situ hybridization (FISH)

Normal or Abnormal with interpretation

Standard Risk mSMART 3.0 abnormalities include:

• a trisomy result of 5, 9, or 15 (or a combination of these)
• a t(6;14) (CCND3/IGH) rearrangement
• a t(11;14) (CCND1/IGH) rearrangement.

High Risk mSMART abnormalities include:

• a t(4;14) (FGFR3/IGH) rearrangement
• a t(14;16) (IGH/MAF) rearrangement
• a t(14;20) (IGH/MAFB) rearrangement

Of note, one high risk abnormality may be ameliorated by a trisomy finding.

Double Hit Myeloma: Any 2 high-risk abnormalities present

Triple Hit Myeloma: 3 or more high risk abnormalities present

Medical necessity