Leukemia / Lymphoma Evaluation, |
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Test Highlights |
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Clinical Use
| • | Differential diagnosis |
| • | Therapeutic monitoring |
| • | Detection of relapse |
Clinical Background
Neoplasms of hematopoietic and lymphoid origin can be characterized by the expression of various cell surface (membrane) markers. Such expression, coupled with morphology, cytochemical stains, chromosome analysis and gene rearrangement studies, is integral to the differential diagnosis that serves as the basis for treatment selection. Following initiation of therapy, significant decreases in the targeted cell populations, as determined by phenotyping, are indicative of therapeutic success. A return or rise in such cell populations indicates relapse of the disorder.
Method
Based on a preliminary review of the available clinical and morphologic information and initial flow cytometric features of the case, the laboratory will select an appropriate panel of 14 cell surface markers. Gating on the proper cell population is based on thorough evaluation of available data, and additional markers may be included for difficult and unusual cases.
CPT Codes:* 88184, 88185 x14, 88188
Interpretive Information
A patient-specific, detailed interpretation is issued by an experienced hematopathologist.
Specimen Requirements
Acceptable sample types and volumes are listed in the following table. Whole blood and bone marrow specimens should be submitted at room temperature along with a stained or unstained freshly prepared smear. Tissue and fluid specimens should be shipped at 4ºC along with a stained H&E slide. Include a clinical summary, differential diagnosis, or pathology report with all samples. Submit promptly since samples should be assayed within 48 hours of collection.
Acceptable Sample Types and Volumes
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| Sample Type | Tube or Container |
Requested Volume | Minimum Volume | |
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| Sodium heparin whole blood | Green-top tube | 5 mL | 1 mL | |
| EDTA whole blood | Green-top tube | 5 mL | 1 mL | |
| ACD solution B whole blood | Yellow-top tube | 5 mL | 1 mL | |
| Sodium heparin bone marrow | Green-top tube | 2 mL | 1 mL | |
| Tissue | RPMI 1640 cell culture medium or Cyto3 transport media* | ~0.5 cm2 | Not applicable | |
| Fluid | Sterile container | >50,000 cells** | 50,000 cells** | |
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| * | Cyto 3 transport media is available from Quest Diagnostics. | |||
| ** | Cells of interest (eg, blast cells). | |||
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This test was developed and its performance characteristics determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.
* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed.
