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Test ID LBOR0241 Myelodysplastic Syndrome (MDS), Diagnostic FISH, Varies


Ordering Guidance


Chromosome analysis is recommended as first-tier testing; order either CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow, or CHRHB / Chromosome Analysis, Hematologic Disorders, Blood. This second-tier test should only be ordered if chromosome analysis is not successful, as it does not increase the sensitivity for detection of myelodysplastic syndrome (MDS) for classic abnormalities (ie, -5/5q-, -7/7q-). If this test is ordered concurrently with a chromosomal study (CHRBM or CHRHB), testing will be held pending the results of the chromosome test. If the chromosome results are complete and informative, this test will be canceled. If the chromosome results are complete and normal, this test will be canceled. If a complete chromosome study is not achieved (<20 metaphases), this test will proceed. If an ambiguous abnormality (may include nonclonal abnormality or unresolved structural abnormality) is observed and targeted MDS probes could be useful in characterizing the abnormality, this test will be canceled and reordered with appropriate probes as MDSMF / Myelodysplastic Syndrome (MDS), Specified FISH, Varies.

 

This test should not be used to screen for residual MDS. If the patient is being treated for known abnormalities, MDSMF / Myelodysplastic Syndrome (MDS), Specified FISH, Varies is the more appropriate test order.

 

This test is intended for instances when the entire MDS fluorescence in situ hybridization (FISH) panel is needed as a second-tier test. If limited MDS FISH probes are preferred, order MDSMF.

 

If this test is ordered in conjunction with AMLAF / Acute Myeloid Leukemia (AML), FISH, Adult, Varies or AMLPF / Acute Myeloid Leukemia (AML), FISH, Pediatric, Varies, it will be canceled and reordered as MDSMF to avoid duplicate FISH probe testing.

 

At follow-up, targeted MDS FISH probes can be evaluated based on the abnormalities identified in the diagnostic study. Order MDSMF / Myelodysplastic Syndrome (MDS), Specified FISH, Varies and request specific probes or abnormalities.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


1. A reason for testing should be submitted with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.

2. A pathology and/or flow cytometry report may be requested, if not received, by the laboratory to optimize testing and aid in interpretation of results.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Bone marrow

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (heparin) or lavender top (EDTA)

Specimen Volume: 2 to 3 mL

Collection Instructions:

1. It is preferable to send the first aspirate from the bone marrow collection.

2. Invert several times to mix bone marrow.

3. Send bone marrow in original tube. Do not aliquot.

 

Acceptable:

Specimen Type: Blood

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (heparin) or lavender top (EDTA)

Specimen Volume: 6 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send whole blood in original tube. Do not aliquot.


Secondary ID

614276

Useful For

Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with myelodysplastic syndromes or other myeloid malignancies using a laboratory-designated probe set algorithm

 

Evaluating specimens in which standard cytogenetic analysis is unsuccessful

Testing Algorithm

This test includes a charge for the probe application, analysis, and professional interpretation of results for 6 probe sets (12 individual fluorescence in situ hybridization probes). Additional charges will be incurred for all reflex or additional probe sets performed.

 

Panel includes testing for the following abnormalities using the probes listed:

-inv(3) or t(3;3), RPN1/MECOM

-5/5q-, D5S630/EGR1

-7/7q-, D7S486/D7Z1

+8, D8Z2/MYC

-17p-, TP53/D17Z1

-20/20q-, D20S108/20qter

 

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.

 

In the absence of RPN1::MECOM fusion, when an extra MECOM signal is identified, reflex testing using the MECOM/RUNX1 probe set will be considered at the laboratory’s discretion to identify a potential t(3;21)(q26.2;q22) rearrangement. Laboratory discretion may be influenced by available karyotype results.

 

In the absence of RPN1::MECOM fusion, when an extra RPN1 signal is identified, reflex testing using the PRDM16/RPN1 probe set will be considered at the laboratory’s discretion to identify a potential t(1;3)(p36;q21) rearrangement. Laboratory discretion may be influenced by available karyotype results.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

MDS, Diagnostic FISH

Specimen Type

Varies

Specimen Minimum Volume

Blood: 2 mL
Bone Marrow: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies 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 12, 88275 x 6, 88291-FISH Probe, Analysis, Interpretation; 6 probe sets

88271 x 2, 88275-FISH Probe, Analysis; each additional probe set (if appropriate)

Forms

If not ordering electronically, complete, print, and send an Hematopathology/Cytogenetics Test Request (T726) with the specimen.