DNA Marker, Post BMT Engraftment, Bone Marrow


Sunquest Code:PENTBMCoPath Code:POSTENFT (BM)
Epic Code:LAB4907Epic Name:DNA Marker, Post BMT Engraft, Bone Marrow
Order Instructions:For blood, use Sunquest Code: PSTNFT, CoPath Code: POSTENFT (B)
Synonyms:Bone Marrow Transplant DNA Marker; Bone Marrow Transplant Engraftment Evaluation; Molecular; Post BMT Chimerism Study, RLFP
Methodology:Amplification of DNA by polymerase chain reaction followed by separation by capillary electrophoresis
CPT Code:----------CPTCODES HERE----------
Test Includes:BMT DNA processing, DNA marker, post-BMT engraftment
Turnaround Time:Performed Mon-Fri; results are reported within 3 days.


Collection Instructions

Specimen:Bone marrow aspirate or bone marrow biopsy, isolated cells from bone marrow.
Container:Yellow (ACD, Solution A) tube available from laboratory (Purple (EDTA))
Collection Instructions:
  • Bone marrow aspirate or bone  marrow (core) biopsy: Aspirate ACD (or EDTA)  solution into syringe from open ACD (or EDTA) tube; collect 5 mL (2 mL minimum) bone marrow into syringe. Deliver in syringe.
  • Isolated cells from bone marrow: Deliver to the lab within 1 hour or freeze.
 
Causes for Rejection:Frozen or clotted bone marrow sample, incorrect anticoagulant.
Shared samples will not be accepted unless sent to Molecular first. Contamination will occur on automated hematology analyzers.  DNA extracted at non-CLIA certified (or equivalent) lab.


Processing and Shipping

Specimen Processing:Store at room temperature.
Shipping Instructions:Ship at room temperature. Must arrive within 24 hours.
Test Performed at or Referral Lab Molecular Diagnostics 


Interpretive

Reference Range:

Bone marrow is not fractionated. Results are reported with the exact percentage of donor engraftment. “Sensitivity: ±5%” indicates the minimum amount of control DNA marker detectable for this specimen. If more than one of the ten STR markers is informative, the average of all informative markers will be the final engraftment result.

 

Use:

Allogeneic hematopoietic cell transplant (HCT) is a therapeutic option available for treatment of numerous malignancies and inherited genetic disorders. Monitoring engraftment following allogeneic HCT is necessary for early documentation of engraftment, detection and timely treatment of graft rejection or early relapse. The presence of lympho-hematopoietic cells of donor origin after allogeneic HCT is referred to as “chimerism”. The kinetics of engraftment in different cell populations has been found to be different among T cells, Natural Killer (NK) cells, granulocytes and monocytes. Generally donor T cell chimerism has been found to lag behind donor myeloid chimerism. Early patterns of T and NK cell chimerism have predicted patients at increased risk of graft rejection and graft versus host disease. Hence lineage-specific chimerism (i.e. monitoring of engraftment is specific subset) may provide valuable clinical information in identifying patients at high risk for adverse clinical events.

 



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