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Test Code TLBLF T-Lymphoblastic Leukemia/Lymphoma, FISH, Tissue


Ordering Guidance


This test does not include a pathology consultation. If a pathology consultation is requested, order PATHC / Pathology Consultation, and appropriate testing will be added at the discretion of the pathologist and performed at an additional charge.

 

Mayo Hematopathology Consultants are involved in both the pre-analytic (tissue adequacy and probe selection, when applicable) and post-analytic (interpretation of fluorescence in situ hybridization [FISH] results in context of specific case, when applicable) phases.

 

This assay detects chromosome abnormalities observed in paraffin-embedded tissue samples of patients with T-lymphoblastic leukemia/lymphoma (T-LBL). If a non-paraffin embedded bone marrow or blood sample is received for this test, the test will be canceled and automatically reordered by the laboratory as TALAF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or TALPF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies depending on the age of the patient.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. A pathology report is required for testing to be performed. If not provided, appropriate testing and/or interpretation may be compromised or delayed. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.

2. The following information must be included in the report provided:

-Patient name

-Block number - must be on all blocks, slides, and paperwork

-Date of collection

-Tissue source

3. A reason for testing must be provided. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

4. A list of probes is required if select probes are necessary or if the patient is being tracked for known abnormalities. See Table in Clinical Information.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tumor tissue block. Blocks prepared with alternative fixation methods will be attempted but are less favorable for successful results; provide fixation method used.

Additional Information:

1. Paraffin embedded specimens can be from any anatomic location (skin, soft tissue, lymph node, etc).

2. Bone specimens that have been decalcified will be attempted for testing, but the success rate is approximately 50%.

 

Acceptable:

Specimen Type: Tissue slides

Slides: 1 Hematoxylin and eosin stained and 2 unstained for each probe set

Collection Instructions:

1. Include 1 hematoxylin and eosin-stained slide for the entire test order.

2. For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides


Secondary ID

65413

Useful For

Detecting recurrent common chromosome abnormalities associated with T-cell acute lymphoblastic leukemia/lymphoma (T-ALL) using client specified probes

 

Identifying and tracking known chromosome abnormalities in patients with T-ALL and monitoring response to therapy

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_I300 Interphases, >=100 No No
_I099 Interphases, 25-99 No No
_IL25 Interphases, <25 No No
_PB03 Probe, +3 No No
_PB02 Probe, +2 No No
_PADD Probe, +1 No No
_PBCT Probe, +2 No No

Testing Algorithm

This test may be ordered in 2 distinct ways allowing different combinations of probes to be utilized based on the clinical question, including the standard (diagnostic) T-lymphoblastic leukemia/lymphoma (TLBL) fluorescence in situ hybridization (FISH) panel and the individual TLBL fluorescence in situ hybridization (FISH) probes (per client request).

 

This test includes a charge for the probe application, analysis, and professional interpretation of results for one probe set (2 individual [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

 

If individual TLBL FISH probes are wanted, the specific probes requested must be noted on the request form or in the reason for referral. If no FISH probes are indicated, the standard (diagnostic) panel will be performed.

 

The standard (diagnostic) panel includes testing for the following abnormalities, using the FISH probes listed:

1p33 rearrangement or STIL deletion, request probe TAL1/STIL

t(5;14)(q35;q32) or TLX3::BCL11B fusion, request probe TLX3/BCL11B

t(7q34;var) or 7q34 rearrangement, request probe TRB break-apart

+9/9p-, request probe CDKN2A/D9Z1

t(9;22) or ABL1 amplification, request probe ABL1/BCR

t(10;11)(p12;q14) or MLLT10::PICALM fusion, request probe MLLT10/PICALM

t(11q23;var) or 11q23 rearrangement, request probe MLL(KMT2A) break-apart

t(14q11.2;var) or 14q11.2 rearrangement, request probe TRAD break-apart

-17/17p-, request probe TP53/D17Z1

 

When an MLL(KMT2A) rearrangement is identified, appropriate reflex testing will be performed with 1 or more dual-fusion (D-FISH) probe sets in an attempt to identify the translocation partner.

Reflex testing is performed for the following abnormalities, using the FISH probes listed:

t(4;11)(q21;q23) or AFF1::MLL(KMT2A) fusion, request probe AFF1/MLL

t(6;11)(q27;q23) or MLLT4(AFDN)::MLL(KMT2A) fusion, request probe MLLT4(AFDN)/MLL

t(9;11)(p22;q23) or MLLT3::MLL(KMT2A) fusion, request probe MLLT3/MLL

t(10;11)(p12;q23) or MLLT10::MLL(KMT2A) fusion, request probe MLLT10/MLL

t(11;19)(q23;p13.1) or MLL(KMT2A)::ELL fusion, request probe MLL/ELL

t(11;19)(q23;p13.3) or MLL(KMT2A)::MLLT1 fusion, request probe MLL/MLLT1

 

When a TRB(TCR beta) rearrangement is identified, reflex testing will be performed with the D-FISH probe set for t(7;10)(q34;q24) TRB::TLX1 fusion in an attempt to identify the translocation partner. To request this probe specifically, request probe TRB/TLX1.

 

When a TRAD(TCR alpha delta) rearrangement is identified, reflex testing will be performed with the D-FISH probe set for t(10;14)(q24;q11.2) TLX1::TRAD fusion in an attempt to identify the translocation partner. To request this probe specifically, request probe TLX1/TRAD.

 

Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

T-Lymphoblastic Leuk/Lymph, FISH,Ts

Specimen Type

Tissue

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Tissue Ambient (preferred)
  Refrigerated 

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

Report Available

7 to 10 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

88271 x 2, 88291-DNA probe, each (first probe set), Interpretation and report

88271 x 2-DNA probe, each; each additional probe set (if appropriate)

88271-DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271 x 2-DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271 x 3-DNA probe, each; coverage for sets containing 5 probes (if appropriate)

88274 w/modifier 52-Interphase in situ hybridization, <25 cells, each probe set (if appropriate)

88274-Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)

88275-Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TLBLF T-Lymphoblastic Leuk/Lymph, FISH,Ts In Process

 

Result ID Test Result Name Result LOINC Value
113467 Result Summary 50397-9
113468 Interpretation 69965-2
113626 Result Table 93356-4
113469 Result 62356-1
GC005 Reason for Referral 42349-1
113470 Specimen 31208-2
113471 Source 31208-2
113472 Tissue ID 80398-1
113473 Method 85069-3
113474 Additional Information 48767-8
113475 Disclaimer 62364-5
113476 Released By 18771-6

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Hematopathology/Cytogenetics Test Request (T726)

-Children's Oncology Group Test Request (T829)