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HelpTest ID ALLM B-ALL Monitoring, MRD Detection, Bone Marrow
Useful For
Aiding in the monitoring of a previously confirmed diagnosis of B-cell lymphoblastic leukemia
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FCINT | Flow Cytometry Interp, 2-8 Markers | No | Yes |
Testing Algorithm
When this test is ordered, flow cytometry interpretation, 2 to 8 markers will always be performed at an additional charge.
Method Name
Immunophenotyping
Reporting Name
B-ALL Monitoring, MRD Detection, BMSpecimen Type
Bone MarrowSpecimen Type: Bone marrow aspirate
Preferred: Yellow top (ACD)
Acceptable: EDTA,
heparin
Specimen Volume: 3 mL
Collection
Instructions:
1. Submission of bilateral specimens is not required.
2. Include 5- to 10-unstained bone marrow aspirate smears, if
possible.
3. Label specimen appropriately (bone marrow).
Specimen Stability Information: Ambient ≤72 hours
Additional Information: If cytogenetic tests are also desired an additional specimen should be submitted. It is important that the specimen be obtained, processed, and transported according to instructions for the other required test.
Forms: If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request Form (T726) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/hematopathology-request-form.pdf)
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Bone Marrow | Ambient | |
Clinical Information
B-cell lymphoblastic leukemia/lymphoma (B-ALL) is a neoplasm of precursor cells (lymphoblasts) committed to B-cell lineage. B-ALL is the most common acute leukemia in children and adolescents, and also occurs in adults. Patients with B-ALL typically present with a high blast count in the peripheral blood, and bone marrow replacement with the disease. The diagnosis of B-ALL is based on a combination of morphologic features showing primarily small blasts with open chromatin and high N:C ratio, and an immunophenotype showing immaturity (CD34 and/or TdT expression) associated with B-cell lineage markers (CD19, CD22, and CD79a).
New therapeutic approaches in B-ALL have been increasingly successful. One of the most important predictors of the disease relapse is the ability to detect minimal residual disease (MRD) in the bone marrow specimens following induction phase of the therapy (day 28). Immunophenotyping studies are necessary as morphologic features are not sufficient to detect MRD. The absence of MRD (at 0.01% sensitivity) is an important prognostic indicator in these patients.
This test is used to establish an antigen footprint of tumor cells at diagnosis to monitor minimal residual disease in these patients after treatments and/or transplants.
Reference Values
An interpretive report will be provided. This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and correlation with the morphologic features will be provided by a hematopathologist for every case.
Cautions
This test is only appropriate for patients who have a previous confirmed diagnosis of B-cell lymphoblastic leukemia. Treatment with antibodies to CD19 may interfere with the ability to detect minimal residual disease (MRD).
Day(s) Performed
Specimens are processed and reported Monday through Saturday
Report Available
1 dayPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
88184-Flow cytometry; first cell surface, cytoplasmic or nuclear
marker
88185 x 7-Flow cytometry; additional cell
surface, cytoplasmic or nuclear marker (each)
88187-Flow
cytometry interpretation, 2 to 8 markers