Ordering Recommendation

Aids in the evaluation of hematopoietic neoplasms (ie, leukemia, lymphoma). Use to monitor therapy in patients with an established diagnosis of hematopoietic neoplasms.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Bone marrow. Whole blood: Green (sodium heparin), lavender (K2EDTA), or pink (K2EDTA). Tissue or fluid.

Specimen Preparation

Bone Marrow: Transport 1 mL heparinized bone marrow (Min: 0.5 mL*)
Whole Blood: Transport 5 mL whole blood. (Min: 1mL*)
Tissue: Transport 100 mg fresh tissue suspended in tissue culture media (e.g., RPMI 1640)
(Min: 100 mg*)
Fluid: Transport 10-100 mL fresh fluid (Min: 3 mL*).
*Minimum volume is dependent on cellularity.

Storage/Transport Temperature

Specimen should be received within 24 hours of collection for optimal cell viability.
Bone marrow or whole blood: Room temperature. Also acceptable: Refrigerated.
Tissue or fluid: Refrigerated.

Unacceptable Conditions

Clotted or hemolyzed specimens.

Remarks

A minimum of 10,000 viable cells is required for flow cytometry phenotyping of samples containing a very limited number of markers (may also be called antibodies or antigens). For low-count specimens, supplying clinical and diagnostic information is especially important to help ensure the most appropriate marker combinations are evaluated before the specimen is depleted of cells.
Bone marrow or whole blood: Provide specimen source, CBC, Wright stained smear (if available), clinical history, differential diagnosis, and any relevant pathology reports.
Tissue or Fluid: Provide specimen source, clinical history, differential diagnosis, and any relevant pathology reports.
Follow up: If previous leukemia/lymphoma phenotyping was performed at another lab, the outside flow cytometry report and histograms (if possible) should accompany the specimen.

Stability

Ambient: 48 hours; Refrigerated: 48 hours; Frozen: Unacceptable

Methodology

Flow Cytometry

Performed

Sun-Sat

Reported

1-2 days

Reference Interval

By report

Interpretive Data

Refer to report.

Compliance Category

Analyte Specific Reagent (ASR)

Note

Flow cytometric immunophenotyping can aid in lineage assignment of acute leukemias and assist in diagnosis and classification of leukemias and lymphomas.

A panel of markers is performed on each case depending on the clinical history and specimen type. Without prior history or additional information, peripheral blood specimens typically undergo a preliminary analysis for B, T, NK, and myeloid/monocytic abnormalities, while bone marrows and lymph nodes undergo additional analysis for plasma cell abnormalities. Additional markers will be run as needed to further characterize abnormal populations.

Available Markers by population*:
T cell: CD1a, CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD25, CD26, CD30, CD200, CD279 (PD-1), TCR gamma-delta, TRBC1, Cytoplasmic CD3
B cell: CD5, CD10, CD11c, CD19, CD20, CD22, CD23, CD25, CD38, CD103, CD123, CD200, surface Kappa, surface Lambda, cytoplasmic Kappa, cytoplasmic Lambda
Plasma cell: CD13, CD19, CD20, CD27, CD33, CD38, CD45, CD56, CD81, CD117, CD138, CD200, cytoplasmic Kappa, cytoplasmic Lambda
Myeloid: CD11b, CD13, CD14, CD15, CD16, CD33, CD34, CD36, CD38, CD41, CD42b, CD45, CD56, CD57, CD61, CD64, CD66b, CD71, CD117, CD123, HLA-DR, myeloperoxidase, glycophorin (CD235a), TdT
B lymphoblasts: CD10, CD19, CD20, CD22, CD24, CD38, CD45, CD58, CLRF2, cCD22, cCD79a
Mast Cell: CD2, CD25, CD30, CD117, CD123

*Not all markers will be reported in all cases. Requests for specific markers to be run must be listed on manual requisition or by footnote for electronic orders. We do not offer individual marker identification separately outside of the markers in this panel.

The report will include a pathologist interpretation and a marker interpretation range corresponding to CPT codes of 2-8 markers, 9-15markers, and 16+ markers interpreted. Charges apply per marker.

Hotline History

N/A

CPT Codes

88184, 88185 each additional marker; 88187 or 88188 or 88189.

Components

Component Test Code* Component Chart Name LOINC
0092286 Number Of Markers 19099-1
2008059 Leuk/Lymph Phenotype, Impression 45267-2
2013914 Leuk/Lymph Phenotype, Source 31208-2
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Chronic Lymphocytic Leukemia Follow up Phenotyping by Flow Cytometry
  • Follow-Up Phenotyping
  • Hematopoietic neoplasms monitoring
  • Leukemia/Lymphoma Evaluation Panel
  • Leukemia/Lymphoma Phenotyping, Comprehensive - Bone Marrow
  • Leukemia/Lymphoma Phenotyping, Comprehensive - Miscellaneous
  • Leukemia/Lymphoma Phenotyping, Comprehensive - Whole Blood
Leukemia/Lymphoma Phenotyping Evaluation by Flow Cytometry