Lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, MYD88 L265P with reflex to CXCR4

Alphabetical Test listing

Lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, MYD88 L265P with reflex to CXCR4-994

Test name:

Test number:

994

Excellian order number:

LAB994

Abbreviation:

MSO

Alternate names:

MYD888
MYD88 L265P
CXCR4
CXLPL
S338X
MYD88 with reflex to CXCR4 B-cell lymphoma
LPL/WM
Lymphoplasmacytic lymphoma
Waldenstrom Macroglobulinemia
CXLPL
S338X

Tests included:

The algorithm starts with the sensitive MYD88 L265P testing by allele-specific polymerase chain reaction.

If a MYD88 L265P variant is detected, additional CXCR4 testing will be performed.
If a MYD88 L265P variant is not detected, the algorithm ends and no further testing is necessary.

Useful for:

Establishing the diagnosis of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (LPL/WM)
Helping distinguish LPL/WM low-grade B-cell lymphoma from other subtypes
Aiding in the prognostication and clinical management of LPL/WM

Specimen type:

Bone marrow

Collection container:

Lavender (EDTA), 4mL

Volume:

2 mL

Minimum volume:

0.5 mL

Collection instructions:

Invert several times to mix bone marrow
Label specimen as bone marrow

Processing instructions:

Do not aliquot
Submit original tube

Transport container:

Lavender (EDTA), 4mL

Alternate specimen type:

EDTA whole blood; ACD whole blood, peripheral

Alternate collection container:

Lavender (EDTA), 4mL

Yellow top (ACD solution B)

Alternate specimen volume:

3.0 mL

Alternate collection instructions:

Invert several times to mix blood
Label specimen as peripheral blood

Alternate processing instructions:

Do not spin; do not aliquot
Submit original tube

Alternate transport container:

Lavender (EDTA), 4mL

Yellow top (ACD solution B)

Required forms/information:

Pertinent clinical history
Clinical or morphologic suspicion
Date and time of collection
Specimen source

Molecular Medicare Billing Request

Hospital clients submitting a request for this assay on an outpatient with Medicare should complete and submit a Molecular Medicare billing request form to notify us of the need for Allina Health Laboratory to bill insurance.

Transport and stability:

Ambient (preferred) - 10 days

Refrigerate - OK

Specimen retention time:

2 weeks

Reason for rejection:

Gross hemolysis
Clotted

Performing lab:

Mayo Clinic Laboratories (LPLFX): R-NX

Days set up:

Mo - Fr

TAT:

7 - 10 days

Method:

Allele-Specific Polymerase Chain Reaction (AS-PCR), Bridged Nucleic Acids (BNA) Clamp Sanger Sequencing and routine Sanger Sequencing

Reference ranges:

Reportable variant present or not detected.

An interpretive report will be provided.

Preauthorization:

This test may require preauthorization from the insurance provider. Check the payer guidelines and, if needed, obtain the pre-authorization prior to sample collection.

CPT codes:

81305

Subject to medical necessity (Y/N):

Yes

Other billing information:

Medical necessity

Molecular Medicare Billing Request

Date created:

04/30/2019

Revised date:

07/27/2026

Review date:

07/27/2026