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BCL2 t(14;18) Gene Rearrangement by PCR

Test Code

M 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

Turnaround Time

3-5 days

Specimen Requirements
    • 5.0 mL (min. 3.0 mL) whole blood EDTA or Sodium Heparin
    • 3.0 mL (min. 1.0 mL) bone marrow EDTA or Sodium Heparin
    • 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

    Whole blood, bone marrow, bone marrow biopsy, fresh tissue or FNA, ship in a Styrofoam container with a cool/refrigerated pack (Do not allow the cool 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
    1. 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.
    2. 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.