CLL full panel by FISH
CLL full panel by FISH-Order the individual components; 4280H (blood) or 4280G (bone marrow)
LAB4280G - CYTOGENETIC BONE MARROW STUDIES
CCND1/IGH
CLL
Chronic Lymphocytic Leukemia
Deletion 6q21
MYC rearrangement
SLL
Small Lymphocytic lymphoma
t(11;14)
Trisomy 12
TP53 deletion
8q24
11p22 deletion
+12
13q14.3 deletion
13q deletion
17p13.1 deletion
- 6q21
- ATM
- CCND1
- CEP12
- DEL13
- IGH
- MYC
- TP53
Detecting the prognostically significant cytogenetics FISH abnormalities used in the CLL/SLL NCCN guidelines
Only one specimen tube is required to perform all ordered cytogenetics testing.
The more testing ordered, the closer to the optimal volume requirements is preferred.
Dk green Sodium heparin (Na hep), no gel
EDTA whole blood (a chromosome analysis study is not recommended for this specimen type)
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
Bone marrow:
Sterile vial/tube
Dk green Sodium heparin (Na hep), no gel
EDTA whole blood:
Lavender (EDTA), 4mL
- 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
Deletion of ATM or TP53 are classified as unfavorable cytogenetics prognostic indicators in CLL/SLL.
Trisomy 12 and deletion of 13q14.3 are classified as neutral, however, CLL cases with a high proportion of cells with a deletion 13q14.3 do not do well.
6q21 deletions do not have any particular prognostic significance but help identify CLL patients when other FISH is negative.
MYC rearrangement is an indication of potential histologic (Richter’s) transformation to a more aggressive lymphoma.
CCND1/IGH is strictly used on newly diagnosed CLL/SLL patients in order to rule out mantle cell lymphoma.