HLX FISH Oncology CASE FISH Onco

Synonyms

Myeloproliferative Disorder (MPD) Probes: PDGRA/FIP1L1 fusion, CHIC2 del(4q12), PDGFRB, FGFR1 (8p11.2) cep 8

Myelodysplastic Disorder (MDS) Probes: -5/ deletion 5q, -7/ deletion 7q, Trisomy 8, Deletion 20q, TP53 (deletion 17p)

Chronic Myeloid Leukemia (CML) Probes: BCR/ABL t(9;22)

Acute Myeloid Leukemia (AML) Probes: -5/ deletion 5q, -7/deletion 7q, RUNX1T1/RUNX1 t(8;21), KMT2A/MLL (11q23), PML/RARA t(15;17), CBFB inv(16)/t(16;16), TP53 (deletion 17p)

Chronic Lymphocytic Leukemia (CLL) Probes: MYB (deletion 6q), ATM (deletion 11q), CCND1/IGH t(11;14), CEP 12 (Trisomy 12), D13S319/LAMP1 (deletion 13q), TP53 (deletion 17p)

Acute Lymphocytic Leukemia (ALL) Probes: MYC t(8q24), BCR/ABL t(9;22), KMT2A/MLL (11q23), ETV6/RUNX1 t(12;21)

Multiple Myeloma Panel Probes: CCND1/IGH t(11;14), RB1 (deletion 13q), IGH/MAF t(14;16), TP53 (deletion 17p)

Lymphoma Panel Probes: BCL6 Break Apart t(3q27), CCND1/IGH t(11;14), MYC Break Apart t(8q24), BIRC3/MALT1 t(11;18), IGH Break Apart (14q32), IGH/BCL2 t(14;18), MYC/IGH t(8;14)

S/P Sex Mismatched Bone Marrow transplant Probes: X,Y

Liposarcoma probes: MDM2/CEP 12 

Allscripts (AEHR) Order Name

FISH Oncology

Sunrise Clinical Manager (SCM) Order Name

Not Orderable

EPIC Order Name

FISH Oncology

Clinical Info

The following panels can be performed on peripheral blood and bone marrow specimens:
1. Myeloproliferative Disorder (MPD) Probes: 
PDGRA/FIP1L1 fusion 
CHIC2 del(4q12)
PDGFRB
FGFR1 (8p11.2) cep 8
2. Myelodysplastic Disorder (MDS) Probes:
-5/ deletion 5q
-7/ deletion 7q
Trisomy 8
Deletion 20q 
TP53 (deletion 17p)
3. Chronic Myeloid Leukemia (CML) Probes: 
BCR/ABL t(9;22)
4. Acute Myeloid Leukemia (AML) Probes: 
-5/ deletion 5q
-7/deletion 7q 
RUNX1T1/RUNX1 t(8;21)
KMT2A/MLL (11q23) 
PML/RARA t(15;17)
CBFB inv(16)/t(16;16) 
TP53 (deletion 17p)
5. Acute Lymphocytic Leukemia (ALL) Probes: 
MYC t(8q24)
BCR/ABL t(9;22)
KMT2A/MLL (11q23)
ETV6/RUNX1 t(12;21)
6. Multiple Myeloma Panel Probes: 
CCND1/IGH t(11;14)
RB1 (deletion 13q)
IGH/MAF t(14;16)
TP53 (deletion 17p)
7. S/P Sex Mismatched Bone Marrow transplant Probes: 
X,Y 
The following panels can be performed on peripheral blood, bone marrow, and lymph node specimens:
8. Chronic Lymphocytic Leukemia (CLL) Probes: 
MYB (deletion 6q)
ATM (deletion 11q)
CCND1/IGH t(11;14)
CEP 12 (Trisomy 12)
D13S319/LAMP1 (deletion 13q)
TP53 (deletion 17p)
The following panel can be performed on peripheral blood, bone marrow, lymph node, and Touch prep specimens:
9. Lymphoma Panel Probes: 
BCL6 Break Apart t(3q27), 
CCND1/IGH t(11;14), 
MYC Break Apart t(8q24), 
BIRC3/MALT1 t(11;18), 
IGH Break Apart (14q32), 
IGH/BCL2 t(14;18), 
MYC/IGH t(8;14)
The following test can be performed on FFPE slides only:
10. Liposarcoma probes: 
MDM2/CEP 12 
PEDIATRIC PANELS:
SINGLE PROBES:
 CML-BCR::ABL t(9;22)
 APL-PML::RARA t(15;17)
 S/P Sex Mismatched BM Transplant (X/Y Probes) 
Pediatric B-ALL Panel
  BCR::ABL t(9;22) 
  CEP4/CEP10/CEP17 
  KMT2A (11q23) 
  ETV6::RUNX1 t(12;21) 
 
Pediatric T-ALL Panel
  BCR::ABL t(9;22) 
  KMT2A/MLL (11q23) 
 
High Risk Pediatric ALL Panel
  ABL1 
  ABL2 
  PDGFRB 
 
AML Panel
  -5/deletion 5q
  -7/deletion 7q
  RUNX1T1::RUNX1 t(8;21)
  KMT2A (11q23) 
  PML::RARA t(15;17) 
  CBFB inv(16)/t(16;16) 
 
MDS Panel 
  -5/deletion 5q
  -7/deletion 7q
  Trisomy 8
  Deletion 20q 

Specimen Type

Blood, Bone Marrow, Tissue, Other

Container

Green Top Tube

Collection Instructions

An indication must be provided with each specimen. The laboratory will not delay or reject testing if this information is not provided, but appropriate testing and interpretation may be compromised.
Peripheral Blood:
Container/Tube:  Green-top (sodium heparin) tube(s)
Specimen:  5-10 mL of sodium heparin whole blood.
Collection Instructions:  Invert several times to mix blood. Other anticoagulants are not recommended and are harmful to the viability of the cells. Label vial with patient’s name and date of birth. Forward promptly. Specimen cannot be frozen.
    
Bone Marrow:
Container/Tube:  Green-top (sodium heparin) tube(s) or Sterile heparinized syringe
Specimen: 5 ml preferred. Minimum 2 ml with sufficient spicules
Collection Instructions:  Invert several times to mix. Other anticoagulants are not recommended and are harmful to the viability of the cells. Label vial with patient’s name and date of birth. Forward promptly. Specimen cannot be frozen. 
  
Lymph Node:
Container/Tube:  Sterile specimen container with sterile saline or RPMI 1640
Specimen: At least 0.5cm3 piece separated aseptically 
Tumor tissue:
Container/Tube:  Sterile specimen container with sterile saline or RPMI 1640
Specimen: At least 0.5cm3 piece separated aseptically 
BM/PB smear for FISH analysis:
Prepare six smears on a clean positively charged glass slide. 1 smear per probe required. Immediately air dry or send it fresh to the laboratory ASAP. Send to the laboratory ASAP at room temperature.
Tissue block/Slides:
4 unstained slides of FFPE tissue section specimen 4-5 micron thick with two unique identifiers, block ID and cut number clearly labeled on the positively charged slides are required. An additional Hematoxylin and Eosin (H&E) slide must be submitted along with the sample clearly marked by a pathologist to denote the area of interest for the FISH study.   
Send to the laboratory ASAP at room temperature. 

Transport Instructions

Transport Temperature: Send to the laboratory ASAP at room temperature 20-25°C. If there is a delay in transportation, store the sample in a refrigerator at 4°C / DO NOT FREEZE

Specimen Stability

48 hours room temperature
If specimen cannot be sent promptly, refrigerate and send ASAP
DO NOT FREEZE

Methodology

Fluorescence In Situ Hybridization (FISH)

Days Performed

Monday through Saturday

Performing Laboratory

Northwell Health Laboratories

CPT

88271 - DNA probe, each
88275 - interphase in situ hybridization
88291 - interpretation and report

PDM

5160520

Result Interpretation

See report.

Forms

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