IgVH Somatic Hypermutation

CPT: 81263
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Test Details

Synonyms

  • IgVH Gene Mutation
  • Immunoglobulin Heavy Chain Variable Region Somatic Hypermutation Analysis

Use

Determines the mutation status of IgVH gene in B lymphocytes, including those of CLL (chronic lymphocytic leukemia). The IgVH gene mutation status is one of the discriminators of clinical outcome in patients with CLL. The mutational status of the immunoglobulin genes expressed by CLL cells can be used to segregate patients into two subsets that have significantly different tendencies for disease progression. Patients with leukemic cells that express unmutated immunoglobulin heavy-chain variable region genes have a greater tendency for disease progression than those who have leukemic cells that express IgVH genes with less than 98% nucleic acid homology with their germ-line counterparts.

Limitations

Results of this test are for investigational purposes only. The performance characteristics of this assay have been determined by LabCorp. The result should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established product or procedure.

Methodology

The immunoglobulin heavy-chain gene variable region (IgVH) somatic hypermutation analysis is performed using extracted patient RNA as starting material. Subsequent amplification of the IgH gene is performed by polymerase chain reaction (PCR). The PCR products are isolated and sequenced. The nucleotide sequence is compared to a consensus germline sequence data base for that VH gene family. The results are reported as percentage of homology between the patient's VH sequence in comparison with the germline VH sequence using the Basic Local Alignment Search Tool (BLAST) for the Immunoglobulin data base at http://www.ncbi.nlm.nih.gov/igblast.

Specimen Requirements

Specimen

Peripheral blood or bone marrow

Volume

1 mL

Minimum Volume

0.5 mL

Container

Lavender-top (EDTA) tube, green-top (heparin) tube, or yellow-top (ACD) tube

Storage Instructions

Maintain specimen at room temperature; stable for three to five days.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
113753 IgVH Somatic Hypermutation 111001 Interpretation: 62365-2
113753 IgVH Somatic Hypermutation 114119 Indication for Study: 42349-1
113753 IgVH Somatic Hypermutation 114120 Specimen Type: 31208-2
113753 IgVH Somatic Hypermutation 111005 Comments: N/A
113753 IgVH Somatic Hypermutation 114122 Detection Parameters: N/A
113753 IgVH Somatic Hypermutation 114123 Result: 48670-4
113753 IgVH Somatic Hypermutation 114124 Electonically Signed by: 19139-5
113753 IgVH Somatic Hypermutation 114125 Methodology: 49549-9
113753 IgVH Somatic Hypermutation 111007 Intended Use: N/A
113753 IgVH Somatic Hypermutation 111009 References: N/A
113753 IgVH Somatic Hypermutation 111008 Disclaimer: N/A

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