Acute Lymphoblastic Leukemia (ALL) Pediatric Profile Featured
Test Code
F PALL
Test Synonyms
BCR/ABL 9q34 t(9;22), MLL 11q23, TEL/AML1 t(12;21), trisomy 4, trisomy 10, trisomy 17
Associations
Acute lymphoblastic leukemia (ALL)
Methodology
Fluorescence in situ Hybridization (FISH)
CPT Codes
88367 x10 - Morphometric analysis, in situ hybridization, automated
88368 x10 - Morphometric analysis, in situ hybridization, manual
88368 x10 - Morphometric analysis, in situ hybridization, manual
Turnaround Time
3 days
Specimen Requirements
- 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
Specimen Stability
- 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
Storage & Handling
- 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.)
Causes for Rejection
Clotted specimen; Specimen exposed to extreme temperature; Anticoagulant toxic to cells; Insufficient number of cells; Improper fixative
Reference Range
See report.
Description
Cytogenetic abnormalities occur in approximately 70% of cases of ALL in adults. Precursor B-cell acute lymphoblastic leukemia (ALL) occur in 85% of children and 20% of adults with acute leukemia. Abnormalities of chromosome number (hypodiploidy, hyperdiploidy) are more common in ALL than in AML. Hyperdiploidy in children with trisomies of chromosomes 4, 10 and 17 is associated with a good prognosis when structural anomalies are absent. Translocation (12;21) is very difficult to observe with conventional cytogenetic techniques. FISH can detect these abnormalities in interphase and metaphase cells.
References
- Karen Seiter. (2009). Acute Lymphoblastic Leukemia, Medscape
- Grant C, Cools J, Michaux L et al. (2006). Cytogenetic and molecular genetics of T-cell acute lymphoblastic leukemia from thymocyte to lymphoblast. Leukemia. 20:1496-1510.
