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Oncology Test Request Form Recommended (ARUP form #43099)

Ordering Recommendation

Recommended FISH panel for children with newly diagnosed ALL.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Non-diluted bone marrow aspirate collected in a heparinized syringe. Also acceptable: Whole blood in green (sodium heparin).

Specimen Preparation

Transfer bone marrow to a green (sodium heparin). Transport 3 mL bone marrow (Min: 1 mL) OR 5 mL whole blood (Min: 2 mL).

Storage/Transport Temperature

Room temperature.

Unacceptable Conditions

Frozen specimens. Clotted or paraffin-embedded specimens.

Remarks
Stability

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

Methodology

Fluorescence in situ Hybridization (FISH)

Performed

Sun-Sat

Reported

3-10 days

Reference Interval

By report

Interpretive Data

Probes included: ETV6/RUNX1, BCR/ABL, CEP4, CEP10, MLL

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Analyte Specific Reagent (ASR)

Note

A processing fee will be charged if this procedure is canceled, at the client's request, after the test has been set up, or if the specimen integrity is inadequate to allow culture growth.  The fee will vary based on specimen type.  To order probes separately, refer to Chromosome FISH, Interphase (2002298).

Other specimen types may be acceptable, contact the Cytogenetics Laboratory for specific specimen collection and transportation instructions.

If cell pellets or dropped cytogenetics slides are submitted, a processing fee will not apply.

This test must be ordered using Oncology test request form #43099 or through your ARUP interface.

Hotline History

N/A

CPT Codes

88271 x5; 88275 x5

Components

Component Test Code* Component Chart Name LOINC
2002720 EER ALL Panel by FISH, Pediatric 11526-1
2002721 ALL Panel by FISH, Pediatric 57802-1
* 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

Acute Lymphoblastic Leukemia (ALL) Panel by FISH, Pediatric