DNA Marker, Post BMT Engraftment, Blood


Sunquest Code:PSTNFTCoPath Code:POSTENFT(B)
Epic Code:LAB4608Epic Name:BMT Marker Post BMT Engraft bld
Order Instructions:For bone marrow use Suquest Code: PENTBM, CoPath Code: POSTENFT(BM)
Synonyms:Bone Marrow Transplant DNA Marker; Bone Marrow Transplant Engraftment Evaluation; Post BMT Chimerism Study; Molecular
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:Blood, isolated cells.
Container:Yellow (ACD, Solution A) tube available from laboratory (Purple (EDTA))
Collection Instructions:
  • Peripheral blood: Collect 10 mL (5 mL minimum) in yellow ACD (Solution A) tube; alternate container: purple (EDTA) tube
  • Isolated cells: Deliver to the lab within 1 hour or freeze.
   
Causes for Rejection:Frozen or clotted blood, 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.
Contraindications:Specimens with WBC <0.5 x 10^9/L will not be isolated into CD3+ and CD33/66 (myeloid) + fractions. Samples greater than 48 hours old will not be separated.


Processing and Shipping

Specimen Processing:Store at room temperature.
Shipping Instructions:Ship at room temperature. Must arrive within 24 hours. Specimens received after 1400 Friday thru Sunday will not be processed until Monday.
Test Performed at or Referral Lab Molecular Diagnostics  (UMMC-East Bank)


Interpretive

Reference Range:

Blood is fractionated into CD3 + (CD8 and CD4 T cells and NK T cells) and CD33/66 (myeloid progenitor cells, monocyts and granulocytes-neutrophils and eosinophils) if WBC is greater than 0.5 x 109/L and sample is <48 hours old. Results are reported with the exact percentage of donor engraftment. "Sensitivity: ±5%" indicates the minimum amount of control DNA marker detectable for this specimen.

 

 

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 subsets) may provide valuable clinical information in identifying patients at high risk for adverse clinical events.


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