Detecting a neoplastic clone associated with the common chromosome abnormalities observed in patients with various T-cell lymphomas using a laboratory-designated probe set algorithm
Tracking known chromosome abnormalities and response to therapy in patients with T-cell lymphoma
Evaluating specimens in which standard cytogenetic analysis is unsuccessful
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
TLPDB | Probe, Each Additional (TLPDF) | No, (Bill Only) | No |
This test includes a charge for the probe application, analysis, and professional interpretation of results for 3 probe sets (6 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled, and no charges will be incurred.
If FISH testing proceeds, all probes in the initial panel will be performed. The initial panel includes testing for the following abnormalities using the probes listed:
14q32.1 rearrangement, TCL1A break-apart
14q11.2 rearrangement, TRAD break-apart**
i(7q), D7Z1/D7S486
+8, D8Z2/MYC
**When a TCL1A rearrangement is not identified and the patient has T-cell prolymphocytic leukemia/lymphoma (T-PLL), reflex testing using the TRAD break-apart probe set will be performed.
See Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm, see in Special Instructions.
Fluorescence In Situ Hybridization (FISH)
+8 (trisomy 8)
Hepatosplenic T-cell Lymphoma
inv(14) - inversion 14
Iso(7q) - isochromosome 7q
T-cell Prolymphocytic Leukemia (T-PLL)
TCL1A (14q32) rearrangement
TRAD (14q11.2) rearrangement
This test includes a charge for the probe application, analysis, and professional interpretation of results for 3 probe sets (6 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled, and no charges will be incurred.
If FISH testing proceeds, all probes in the initial panel will be performed. The initial panel includes testing for the following abnormalities using the probes listed:
14q32.1 rearrangement, TCL1A break-apart
14q11.2 rearrangement, TRAD break-apart**
i(7q), D7Z1/D7S486
+8, D8Z2/MYC
**When a TCL1A rearrangement is not identified and the patient has T-cell prolymphocytic leukemia/lymphoma (T-PLL), reflex testing using the TRAD break-apart probe set will be performed.
See Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm, see in Special Instructions.
Varies
This test is intended for instances when a non-specific T-cell lymphoma fluorescence in situ hybridization (FISH) panel is needed.
If limited T-cell lymphoma FISH probes are preferred, order TLPMF / T-Cell Lymphoma, Specified FISH, Varies.
This test should only be ordered if the sample is known to have a sufficient clonal T-cell population. If a flow cytometry result is available and does not identify a sufficient clonal T-cell population, this test will be canceled, and no charges will be incurred.
For testing paraffin-embedded tissue samples from patients with T-lymphoblastic lymphoma (T-BLB), see TLBLF / T-Lymphoblastic Leukemia/Lymphoma, FISH, Tissue.
For patients with T-cell acute lymphoblastic leukemia/lymphoma (T-ALL/LBL), order either TALAF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies. or TALPF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (T-ALL/LBL), FISH, Pediatric, Varies depending on the age of the patient.
Advise Express Mail or equivalent if not on courier service.
A reason for testing and a flow cytometry and/or a bone marrow pathology report 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.
Question ID | Description | Answers |
---|---|---|
GC138 | Reason for Referral | |
GC139 | Specimen |
Whole blood ACD Bone marrow ACD Whole blood Na Hep Bone marrow Na Hep Whole blood EDTA Bone marrow EDTA |
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: 2-3 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.
Acceptable
Specimen Type: Blood
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions: Invert several times to mix blood.
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Blood: 2 mL
Bone Marrow: 1 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Ambient (preferred) | ||
Refrigerated |
Detecting a neoplastic clone associated with the common chromosome abnormalities observed in patients with various T-cell lymphomas using a laboratory-designated probe set algorithm
Tracking known chromosome abnormalities and response to therapy in patients with T-cell lymphoma
Evaluating specimens in which standard cytogenetic analysis is unsuccessful
This test includes a charge for the probe application, analysis, and professional interpretation of results for 3 probe sets (6 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
When this test and flow cytometry testing for leukemia/lymphoma are ordered concurrently, the flow cytometry result will be utilized to determine if sufficient clonal T-cells are available for FISH testing. If the result does not identify a sufficient clonal T-cell population, this FISH test order will be canceled, and no charges will be incurred.
If FISH testing proceeds, all probes in the initial panel will be performed. The initial panel includes testing for the following abnormalities using the probes listed:
14q32.1 rearrangement, TCL1A break-apart
14q11.2 rearrangement, TRAD break-apart**
i(7q), D7Z1/D7S486
+8, D8Z2/MYC
**When a TCL1A rearrangement is not identified and the patient has T-cell prolymphocytic leukemia/lymphoma (T-PLL), reflex testing using the TRAD break-apart probe set will be performed.
See Bone Marrow Staging for Known or Suspected Malignant Lymphoma Algorithm, see in Special Instructions.
T-cell neoplasms are relatively uncommon, accounting for approximately 12% of all non-Hodgkin lymphomas. There are several subtypes of T-cell neoplasms: T-lymphoblastic leukemia (T-ALL), T-cell prolymphocytic leukemia (T-PLL), T-cell large granular lymphocytic leukemia (T-LGL), anaplastic large cell lymphoma (ALCL), peripheral T-cell lymphoma, and various other cutaneous, nodal, and extranodal lymphoma subtypes.
There are a few common chromosome abnormalities associated with specific T-cell lymphoma subtypes evaluated by this fluorescence in situ hybridization (FISH) test, as seen in the following table.
Table. Common Chromosome Abnormalities in T-cell Lymphomas
Lymphoma subtype | Chromosome abnormality | FISH probe |
T-cell prolymphocytic leukemia/lymphoma (T-PLL) | inv(14)(q11q32) and t(14;14)(q11;q32) | 5'/3'TCL1A |
Reflex: 14q11.2 rearrangement | 5'/3'TRAD | |
Hepatosplenic T-cell lymphoma | Isochromosome 7q | D7Z1/ D7S486 |
Trisomy 8 | D8Z2/MYC |
These probes have diagnostic relevance and can also be used to track response to therapy.
An interpretive report will be provided.
A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for any given probe.
Detection of an abnormal clone supports a diagnosis of a T-cell lymphoma. The specific abnormality detected may help subtype the neoplasm.
The absence of an abnormal clone does not rule out the presence of lymphoma.
This test is not approved by the U.S. Food and Drug Administration, and it is best used as an adjunct to existing clinical and pathologic information.
Bone marrow is the preferred sample type for this fluorescence in situ hybridization test. If bone marrow is not available, a blood specimen may be used if there are neoplastic cells in the blood specimen (as verified by a hematopathologist).
1. Swerdlow SH, Campo E, Harris NL, et al, eds: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Volume 2. IARC Press; 2017
2. Gesk S, Martin-Subero JI, Harder L, et al: Molecular cytogenetic detection of chromosomal breakpoints in T-cell receptor gene loci. Leukemia. 2003;17:738-745. doi: 10.1038/sj.leu.2402884
3. Chin M, Mugishima H, Takamura M, et al: Hemophagocytic syndrome and hepatosplenic (gamma)(delta) T-cell lymphoma with isochromosome 7q and 8 trisomy. J Pediatr Hematol Oncol. 2004;26(6):375-378. doi: 10.1097/00043426-200406000-00008
This test is performed using commercially available and laboratory-developed probes. Rearrangements involving TCL1A and TRAD are detected using a dual-color break-apart strategy probe. Trisomy of chromosome 8 and isochromosome 7q are detected using enumeration strategy probes. For each probe set, 100 interphase nuclei are scored. All results are expressed as the percent abnormal nuclei.(Unpublished Mayo method)
Monday through Friday
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.
88271 x6, 88275 x3, 88291 x1- FISH Probe, Analysis, Interpretation; 3 probe set
88271 x2, 88275 x1 - FISH Probe, Analysis; each additional probe set (if appropriate)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
TLPDF | T-cell Lymphoma B/BM, Diag FISH | 101682-3 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
614337 | Result Summary | 50397-9 |
614338 | Interpretation | 69965-2 |
614339 | Result Table | 93356-4 |
614340 | Result | 62356-1 |
GC138 | Reason for Referral | 42349-1 |
GC139 | Specimen | 31208-2 |
614341 | Source | 31208-2 |
614342 | Method | 85069-3 |
614343 | Additional Information | 48767-8 |
614344 | Disclaimer | 62364-5 |
614345 | Released By | 18771-6 |