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Acute Lymphoblastic Leukemia (ALL) Adult Profile

BCR/ABL 9q34 t(9;22), MLL t(11q23),/ TEL/AML1 ES t(12;21), MYB del 6q

F AALL

Test Synonym:

Adult ALL profile

Associations:

Acute Lymphoblastic Leukemia

CPT Code:

88367x8 – Morphometric analysis, in situ hybridization, automated
88368x8 – Morphometric analysis, in situ hybridization, manual

Turnaround Time:

2-4 days

Methodology:

Fluorescence in situ Hybridization (FISH)

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 mm3 fresh tissue in MPLN RPMI media
  • 3.0 ml (min. 2.0ml) FNA in MPLN RPMI media
  • 10% neutral buffered formalin fixed paraffin embedded tissue

    • Causes for Rejection:

    Clotted specimen; specimens exposed to extreme temperature; anticoagulant toxic to cells; insufficient number of cells; improper fixative

    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 and 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)

    Reference Range:

    See report

    Indication:

    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:

    1. http://www.emedicine.com/MED/topic3146.htm
    2. Graux C, Cools J, Michaux L, et al.(2006) Cytogenetics and molecular genetics of T-cell acute lymphoblastic leukemia: from thymocyte to lymphoblast. Leukemia 20:1496-1510