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Plasma Cell Neoplasms Panel by FISH

Test Code

F MM

Test Synonyms

1p-, 1q+, 5,+9, t(11;14), 13q-, +15, 17p-, reflex t(4;14) / t(14;16)

Associations

Multiple Myeloma

Reflex testing
F MM will be auto reflexed to F FGFR3 t(4;14) and F IGH MAF t(14;16) when IGH is rearranged with a locus other than BCL1
Methodology

Fluorescence in situ Hybridization (FISH)

1p32.3 (CDKN2C)/1q21 (CKS1B)
5p15.31 (D5S630,D5S2064)/5q31.2 (EGR1)
CEP 9 (D9Z1)
11q13 (CCND1)/14q32.3 (IGH)
CEP 15 (D15Z4)
13q14.3 (D13S319)/13q34
17p13 (TP53)/CEP17 (D17Z1)

Turnaround Time

3-5 days

Specimen Requirements

5mL peripheral blood in sodium heparin
3mL bone marrow in sodium heparin
Fixed cytogenetically prepared cells in sterile centrifuge tube with pellet visible in 3:1, Methanol:Acetic Acid

Specimen Stability
Blood and bone marrow = 4°C to 25°C, specimens are stable up to 72 hours
Fixed cell pellets are stable for years when stored at -28°C to 15°C
Storage & Handling

4°C to 25°C during transit, but specimens may be transported on refrigerated gel packs. Do not allow the gel pack to come in contact with the specimen. Do not freeze. Extreme temperatures should be avoided.

Causes for Rejection

Clotted specimen; Specimens exposed to extreme temperature; Anticoagulant toxic to cells; Insufficient number of cells

Reference Range

See report

Description

Cytogenetic studies using chromosome analysis and interphase fluorescence in situ hybridization (FISH) are routine procedures for prognostic stratification of plasma cell myeloma. Several cytogenetic abnormalities such as t(4;14), del(17/17p), t(14;16), nonhyperdiploidy, and gain(1q) were shown to confer poor prognosis. Bone marrow samples used for plasma cell neoplasia testing are sorted for CD138 positive selection cells using magnetic beads. FISH analysis on the CD138 positive selected cells has been shown to increase diagnostic sensitivity. 

In cases with inadequate /insufficient sample, CD138+ enrichment will not be attempted.”

References
  1. Palumbo A, Herve A, Stefania O, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol September 2015 33:2863-2869.
  2. Ross F, Herve A, Ameye G, et al. Report from the European Myeloma Network on interphase FISH in multiple myeloma and related disorders. Haematologica August 2017 97:1272-1277.