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Chromosome Analysis, Leukemia/Lymphoma With Reflex to Chromosome Microarray (CMA)

CPT: Contact CPT coding department at 800-222-7566, ext 6-8400.
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Synonyms

  • Hematologic Disorders, Chromosome Analysis
  • Philadelphia Chromosome

Test Includes

Short- and (in some cases) long-term β-mitogen culturing of specimens, chromosome preparation, and analysis of 20 metaphases; multiple karyotypes prepared, including all abnormal clones; reflex to SNP microarray (Reveal®) if chromosome analysis is normal


Special Instructions

Indicate the tentative diagnosis on the test request form. This is necessary for proper culturing and result interpretation. Please direct any questions regarding this test to customer service at 800-345-4363.


Expected Turnaround Time

11 - 21 days



Related Documents


Specimen Requirements


Specimen

Bone marrow, blood (>4% blasts required; see Collection), lymph node, spleen, bone core, or effusion


Volume

2 mL bone marrow, 3 mL peripheral blood, or 0.5 to 1 cm³ tissue


Container

Bone marrow or peripheral blood in pediatric green-stopper (sodium heparin) tube; lymph node, spleen, bone core, or effusion in lymph node transport bottle


Collection

The requirement of >4% blasts for blood does not apply to cases of CLL, hairy cell leukemia, and some cases of small cell lymphocytic leukemia (SCLL) or lymphoma, which can be β-mitogen stimulated. Submit bone marrow or peripheral blood at room temperature using the Leukemia/Lymphoma Specimen Transport Kit (supplied by LabCorp). Submit lymph node, spleen, or bone core at room temperature using Lymph Node Transport Kit (supplied by LabCorp). Effusions may be sent in the same sterile containers. Specimens should arrive in the laboratory within 48 hours of collection. Indicate date and time of collection on the test request form.


Storage Instructions

Maintain specimen at room temperature.


Patient Preparation

Patient should not be on chemotherapy.


Causes for Rejection

Hemolysis; gross contamination; nonneoplastic cells; clotted specimen; frozen specimen; fixed specimen; use of improper or too much anticoagulant. For SNP microarray, quantity not sufficient for analysis, gel-separator tubes, microtainer tubes, fixed cell pellet.


Test Details


Use

Karyotyping, physical localization of copy number changes, and mapping of breakpoints involved in translocations for the diagnosis/prognosis of leukemia/lymphoma subgroups. The SNP assay will detect chromosomal imbalance that may be present in neoplastic disorders and clonal evolution.It provides detection of copy-neutral loss of heterozygosity of any chromosome, and the percent and location of homozygosity, that may be associated with cancer gene mutations.


Limitations

In studies of myeloid malignancy (eg, MDS in blood), availability of immature blasts, excessive amounts of sodium heparin, or use of lithium heparin, or EDTA will inhibit growth of cell culture. The SNP assay does not detect balanced rearrangements, low-level mosaicism (<10%), marker chromosomes that only contain heterochromatin or tetraploidy.

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.


Methodology

Short-term cell culture; synchronization; chromosome harvest; G-banding; analysis (20 metaphases) and karyotyping; long-term β-mitogen cultures in some β-cell leukemias. Reflex to Reveal® microarray if chromosome analysis is normal. SNP microarray analysis is performed using the Cytoscan® HD platform, which uses more than 743,000 SNP probes and 1,953,000 NPCN probes with a median spacing of 0.88 kb.


LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
511040 Chromo Leuk/Lymph Rfx CMA 510678 Specimen Type 31208-2
511040 Chromo Leuk/Lymph Rfx CMA 510679 Cells Counted 62361-1
511040 Chromo Leuk/Lymph Rfx CMA 510680 Cells Analyzed 62360-3
511040 Chromo Leuk/Lymph Rfx CMA 510681 Cells Karyotyped 55199-4
511040 Chromo Leuk/Lymph Rfx CMA 510682 GTG Band Resolution Achieved 62358-7
511040 Chromo Leuk/Lymph Rfx CMA 510683 Cytogenetic Result 62356-1
511040 Chromo Leuk/Lymph Rfx CMA 511029 Interpretation 62365-2
511040 Chromo Leuk/Lymph Rfx CMA 511032 Director Review: 48672-0
511040 Chromo Leuk/Lymph Rfx CMA 052323 Reflex n/a
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510779 Reveal (SM) SNP CMA - Oncology 510795 Specimen Type 31208-2
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510779 Reveal (SM) SNP CMA - Oncology 510796 # of Genotyping Targets n/a
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510779 Reveal (SM) SNP CMA - Oncology 510797 Diagnosis 62357-9
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510779 Reveal (SM) SNP CMA - Oncology 510798 Interpretation 62365-2
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510779 Reveal (SM) SNP CMA - Oncology 510799 Director Review: 48672-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 510779 Reveal (SM) SNP CMA - Oncology 512123 PDF 51967-8

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