BCL2 t(14;18) Gene Rearrangement
Test Code
P BCL2
Test Synonyms
JH gene rearrangement
Associations
B-cell lymphoma, Follicular lymphoma, Diffuse large cell lymphoma, Mantle lymphoma, MALT lymphoma
Methodology
Polymerase chain reaction (PCR), Capillary gel electrophoresis
CPT Codes
83891 - Molecular isolation
83900 - Amplification first two nucleic acid sequences
83901 x5 - Amplification each additional multiplex reaction
83909 - Identification by capillary electrophoresis
83912 - Interpretation and report
83907 - Lysis of cells paraffin block
83900 - Amplification first two nucleic acid sequences
83901 x5 - Amplification each additional multiplex reaction
83909 - Identification by capillary electrophoresis
83912 - Interpretation and report
83907 - Lysis of cells paraffin block
Turnaround Time
3 days
Specimen Requirements
- 5.0 mL (min. 3.0 mL) EDTA whole blood
- 3.0 mL (min. 1.0 mL) EDTA bone marrow
- 5 mm^3 bone marrow core biopsy, fresh or frozen tissue in MPLN RPMI
- 3.0 mL (min. 2.0 mL) FNA in MPLN RPMI medium
- Formalin fixed paraffin embedded tissue
Specimen Stability
- EDTA whole blood or bone marrow stable at 18-25°C for 72 hours
- Bone marrow biopsy, fresh tissue or FNA in MPLN RPMI at stable at 2-8°C for 72 hours
- Frozen tissue at -20°C stable indefinitely
- Paraffin-embedded tissue at 18-25°C stable indefinitely
Storage & Handling
- EDTA whole blood, bone marrow, bone marrow biopsy, fresh tissue or FNA, ship in a Styrofoam container with an ice pack (Do not allow the ice pack to directly contact the sample)
- Frozen tissue, ship on dry ice
- Paraffin embedded tissue ship ambient
Causes for Rejection
Insufficient volume; Specimen at incorrect temperature; Incorrect anticoagulant or fixative
Reference Range
BCL-2 gene rearrangement not detected
Description
Complementary molecular testing strategy (in combination with flow cytometry and FISH) for the detection of the t(14;18) in follicular center lymphoma (FCCL) and diffuse large B-cell lymphoma (DLBCL) and for the differentiation of FCCL/DLBCL from other B-cell lymphomas with similar morphology. The translocation is found present in ~70% of follicular lymphomas and ~30% of diffuse large B-cell lymphomas. While FISH, with almost 100% clinical sensitivity, is the preferred confirmatory test for the detection of the t(14;18), PCR can be used for minimal residual disease monitoring.
References
- Weinberg OK et al. (2007). “Minor” BCL2 breakpoints in follicular lymphoma. Frequency and correlation with grade and disease presentation in 236 cases. J Molec Diagn. 9:530-537.
- Van Dongen JJM et al. (2003). Design and standardization of PCR primers and protocols for detection and clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerned Action BMH4-CT98-3936. Leukemia. 17:2257-2317.
