Leukemia/Lymphoma Immunophenotyping Profile


Sunquest Code:FLOLLCoPath Code:FLOW
Epic Code:LAB4905Epic Name:Leukemia Lymphoma Evaluation
Order Instructions:For CSF specimens order Leukemia Lymphoma Evaulation, CSF
Synonyms:Acute Leukemia Immunophenotyping; Chronic Leukemia Immunophenotyping; Leukemia Cell Surface Markers; ALL Immunophenotyping; AMML Immunophenotyping; AML Immunophenotyping; CML-BC Immunophenotyping; CLL Immunophenotyping; Lymphoma Cell Surface Markers; Multiple Myeloma; LGL; NK Cells; CD49d; Flow Cytometry; Hairy Cell Leukemia; Acute Lymphoid Leukemia; Acute Myeloid/Monocytic Leukemia; Chronic Lymphocytic Leukemia; Chronic Myeloid Leukemia (Blast Crisis); Large Granular Lymphocytes; Natural Killer Disorders; TdT (Terminal Deoxynucleotidyl Transferase); MRD Analysis by Flow Cytometry; KIR by Flow Cytometry; V Beta Analysis by Flow Cytometry
Methodology:Multi-color immunofluorescence and flow cytometry
CPT Code:----------CPTCODES HERE----------
Test Includes:Specific combination of monoclonal antibodies which may include: Characterization of B or T cell malignant lymphomas, B lymphocyte markers including kappa and lambda, HLA-DR, monocytic, myeloid, and/or pan histiocytic/monocytic markers, T lymphocyte markers, plasma cell markers, natural killer markers Tdt, MPO, CD49d, and interpretation of results by pathologist.
Turnaround Time:Performed Mon-Fri; results are reported within 1-3 days.
Special Instructions:Provide diagnosis, age, collection date and time, specimen type, WBC and leukocyte differential.
Testing is performed Mon-Fri, 8 am - 5 pm and on specimens arriving in the Flow Cytometry lab on Saturday before noon. No testing is performed on Sundays or holidays. Contact the IFC laboratory at 612-273-5248 for further information. If testing is needed outside of scheduled hours, contact the hematopathology fellow.
Compliance:

This test was developed and its performance characteristics determined by University of Minnesota Medical Center, Fairview Clinical Laboratories. It has not been cleared or approved by the US Food and Drug Administration. FDA does not require this test to go through premarket FDA review. This test is used for clinical purposes and should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) as qualified to perform high complexity clinical testing.



Collection Instructions

Specimen:Blood, involved bone marrow, vitreous fluid or cellular body fluid, or fresh tissue.
Optimal Volume:8 mL blood; 5 mL involved bone marrow, 0.5 mL vitreous fluid, 20 mL cellular body fluid, or 0.5 cm^3 fresh tissue
Minimum\Peds Volume:2 mL blood; 2 mL involved bone marrow, 0.5 mL vitreous fluid, 5 mL cellular body fluid, or 0.5 cm^3 fresh tissue
Container:Purple (EDTA) (Container, Tissue, sterile, See Collection Instructions)
Collection Instructions:
Collect all specimens aseptically.
  • Blood: Collect in purple top (EDTA) tube, mix well.
  • Bone marrow: Collect in a sterile syringe with 0.5-1.0 mL of 1000 unit heparin per 5 mL of bone marrow to prevent clotting.
  • Vitreous fluid: Collect in a sterile container with 100 units of heparin and 0.4 mL of sterile saline.
  •  Body fluids: Collect in a sterile container with 25 units of heparin per mL of body fluid to prevent clotting.
  • Fresh tissue: Promptly place collected tissue in a sterile container with tissue support media (RPMI). Do not use formalin. Do not freeze.
Samples are received in the Flow Cytometry laboratory for testing Monday - Friday and until noon on Saturday. Samples are not tested on holidays. Samples are received in the Core Lab when the Flow Cytometry lab is not staffed. Viability is assessed on specimens greater than 48 hours old. If testing is needed outside of scheduled hours, contact the hematopathology fellow.    
Causes for Rejection:
Improper specimen collection or handling, clotted speicmen, specimens received >48 hours after collection, formalin-fixed tissue, frozen specimens.  


Processing and Shipping

Specimen Processing:Do not centrifuge. Store in refrigerator. Contact IFC Laboratory prior to sending specimen.
Shipping Instructions:Ship at room temperature. Must arrive within 24 hours.
Test Performed at or Referral Lab Immunophenotyping and Flow Cytometry  (UMMC-East Bank)


Interpretive

Reference Range:

By report

 

 

Use:Differentiate lymphoma from other cancers and non-malignant processes such as lymphoid hyperplasia. Evaluation of lymphocytosis and identification of lymphoproliferative disorders of blood and bone marrow. Identify various types of malignant lymphoma (B cell versus T cell) and provide immunophenotypic subclassification for many lymphoproliferative disorders (hairy cell leukemia, chronic lymphocytic leukemia, mantle cell lymphoma). Differentiate lymphoma and acute leukemia. Distinguish acute myeloid leukemia (AML) from acute lymphoblastic leukemia (ALL). Subtype ALL into B-cell ALL or T-cell ALL. Monitor for minimal residual disease in ALL. Identify monoclonal plasma cells.
The sensitivity of this assay depends on the imunophenotype of the population, the specimen (blood vs. bone marrow vs. tissue vs. CSF), the number of events collected, and the presence or absence of background non-neoplastic cells. Sensitivities listed are general guidelines.
  • The analytic sensitivity of this assay to detect a CD5 positive cell clone or a CD10 positive B cell clone is 0.5%.
  • The analytic sensitivity of this assay to detect a CD5 negative and CD10 negative B cell clone is greater than 1% (>1%).
  • The analytic sensitivity of this assay to detect an abnormal myeloid blast population is 0.5%.
  • The analytic sensitivity of this assay to detect monotypic plasma cells as rare flow events is 0.01%.
  • The analytic sensitivity of this assay to detect an abnormal B-lymphoblast population as rare flow events is 0.01%.
  • The analytic sensitivity of this assay to detect a paroxymal nocturnal hemoglobinuria-like clone (PNH-like clone) as rare flow events is 0.01%.
     


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