Molecular Pathology Laboratory Network

F SRY

SRY region, Yp11.3/Xp11.1q11.1

Bone marrow transplant

Fluorescence in situ Hybridization (FISH)

88367 x2 - Morphometric analysis, in situ hybridization, automated
88368 x2 - Morphometric analysis, in situ hybridization, manual

3 days

• 2.0 mL (min. 1.0 mL) peripheral blood in sodium heparin preferred, EDTA accepted
• 1.0 mL (min. 0.5 mL) bone marrow in sodium heparin preferred, EDTA accepted
• 5 mm^3 fresh tissue in MPLN RPMI media
• 3.0 mL (min. 2.0 mL) FNA in MPLN RPMI media
• 10% neutral buffered formalin fixed paraffin embedded tissue

• Peripheral blood and bone marrow stable at 18-25°C for 72 hours
• Fresh tissue or FNA stable at 2-8°C for 72 hours

• Whole blood and bone marrow, ship ambient
• Fresh tissue, FNA or paraffin embedded tissue, ship in a Styrofoam container with an ice pack (Do not allow ice pack to directly contact sample)

Clotted specimen; Specimen exposed to extreme temperature; Anticoagulant toxic to cells; Insufficient number of cells; Improper fixative

In a normal male cell, the expected pattern is the one orange, one green signal pattern. In a normal female cell, the two orange single pattern is observed.

Bone marrow transplantation is an essential step in the management of a variety of hematological malignancies. Engraftment success can be assessed in sex-mismatched transplants by determining the sex chromosome constitution in hematopoietic cells from the transplant recipient. FISH is one of the most widely used procedures for evaluating engraftment success and for the early detection of graft failure. The CEP X/Y FISH test can be performed on interphase cells or metaphase spreads to determine the proportion of cell derived from the donor versus those derived from the recipient. The identification of chimerism (the presence of two distinct cell lines, one population from the donor and the other population from the recipient) is predictive of imminent relapse and thus impacts treatment decisions.

The CEP X/Y probe mixture is an FDA-cleared assay that utilizes probes specific for the centromeric regions of the X and Y chromosomes. A female pattern is determined by the detection of two orange signals, while a male pattern is identified by the presence of one orange and one green signal. A mixture of male and female cells is consistent with the presence of chimerism.
FISH can detect this in interphase and metaphase cells.