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Laboratory Test Directory

Hematologic Cancer Fusion Analysis

Components

Name Method Department Units
Hematologic Cancer Fusion Analysis Anchored Multiplex PCR (AMP)
Next Generation Sequencing (NGS)
Molecular Genetics

Specimen Requirements

Whole blood

Container Type Container Size Specimen Volume
Preferred

Purple tube (EDTA)

4 mL 4 mL
Stability

Room temperature - 24 hour(s)
Refrigerated - 48 hour(s)

Specimen Preparation

  • Transfer 4 mL bone marrow or whole blood to COG ALL shipping media
  • If COG ALL shipping media is unavailable, transfer 4 mL bone marrow or whole blood to tissue culture media
  • If delay in transport is greater than 24 hours, refrigerate
  • Transport to the lab immediately after collection
  • Liquid tumor sample must contain a minimum of 10% blasts

Bone marrow

Container Type Container Size Specimen Volume
Preferred

Purple tube (EDTA)

4 mL 4 mL
Stability

Room temperature - 24 hour(s)
Refrigerated - 48 hour(s)

Specimen Preparation

  • Transfer 4 mL bone marrow or whole blood to COG ALL shipping media
  • If COG ALL shipping media is unavailable, transfer 4 mL bone marrow or whole blood to tissue culture media
  • If delay in transport is greater than 24 hours, refrigerate
  • Transport to the lab immediately after collection
  • Liquid tumor sample must contain a minimum of 10% blasts

Tissue (Fresh)

Container Type Container Size Specimen Volume
Alternate

Sterile container with saline

N/A mass 0.05 grams
Stability

Room temperature - 24 hour(s)

Specimen Preparation

  • Transport to the lab immediately after collection
  • Keep at room temperature
  • Tumor sample must contain a minimum of 10% tumor

Tissue (Snap-frozen)

Container Type Container Size Specimen Volume
Preferred

Tissue cassette

N/A mass 0.05 grams
Alternate

Cryogenic tube

N/A mass 0.05 grams
Stability

Frozen - 24 hour(s)

Specimen Preparation

  • Freeze immediately after collection.
  • Keep frozen
  • Protect from heat
  • Transport to laboratory as soon as possible
  • Tumor sample must contain a minimum of 10% tumor

OCT-embedded tissue

Container Type Container Size Specimen Volume
Alternate

Tissue cassette

N/A mass 0.05 grams
Alternate

Cryogenic tube

N/A mass 0.05 grams
Stability

Frozen - 24 hour(s)

Specimen Preparation

  • Freeze immediately after collection.
  • Keep frozen
  • Protect from heat
  • Transport to laboratory as soon as possible
  • Tumor sample must contain a minimum of 10% tumor

Reasons for Rejection

  • Delayed or improper handling
  • Wrong type of specimen
  • Wrong collection tube
  • Wrong temperature
  • Insufficient tumor content in tumor sample

Comments

Please click on the Lab Form link in the Forms Section to print and complete the Oncology Genetic Test Requisition Form. Submission of a completed Test Requisition Form is required, and submission of informed consent form is recommended (but not required). Please send all samples via overnight delivery. Saturday deliveries are accepted; please check Saturday Delivery on shipment labels.

This test is designed for patients suspected to have hematologic malignancies. Chromosomal translocations resulting in gene fusions are a hallmark of hematologic neoplasias and can help define the diagnosis and potential treatment options. Specimen containing 10% disease content or greater is required to report out a negative result. If internal pathology review determines that the sample contains less than 10% tumor content, then the test may be cancelled. Sample acquisition prior to receiving therapy is also strongly preferred. At this time, formalin fixed paraffin embedded (FFPE) tissue is NOT an acceptable sample type for this assay.

This panel provides fusion information for 148 gene fusion partners relevant to lymphoid and myeloid malignancies as well as lymphomas, including gene fusion partners associated with Philadelphia chromosome-like (Ph-like) B-cell acute lymphoblastic leukemia, and some, but not all IGH-CRLF2 gene fusions. All positive results are confirmed with RT-PCR with Sanger sequencing. Please note, this test is not recommended as a first-line diagnostic assay for lymphomas due to reduced sensitivity for detecting genomic rearrangements with cancer associated immunoglobulin loci (IgG, IgL, IgK). Lymphomas that have tested negative for Ig rearrangements by FISH or other methodologies are acceptable. The fusion partner genes included in this panel are listed below:

AICDA, ASB13, BCL2A1, BCL3, ALK, BCL11B, BATF3, BCL2, ABL1, ABL2, BCL6, BCR, BIRC3, BLNK, BMF, BMP7, CBFB, CCDC50, CCND1, CCND2, CCND3, CD274, CD44, CDC25A, CDK6, CDKN2A, CDKN2B, CEBPA, CEBPD, CEBPE, CEBPG, CHD1, CHIC2, CIITA, CREB3L2, CREBBP, CRLF2, CSF1R, CTLA4, CYB5R2, DEK, DENND3, DNMT3B, DNTT, DUSP22, E2F2, EBF1, EIF4A1, ENTPD1, EPOR, ERG, ETV6, EXOC2, FAM216A, FGFR1, FLT3, FOXP1, FUT8, GLIS2, HOXA10, HOXA9, ID4, IKZF1, IKZF2, IKZF3, IL16, IRF4, IRF8, ITPKB, JAK2, KAT6A, KIAA0101, KLF2, KMT2A, LIMD1, LMO1, LMO2, LRMP, LYL1, LZTS1, MAL, MALT1, MAML3, MECOM, MKL1, MLF1, MLLT10, MLLT4, MME, MUC1, MYBL1, MYC, MYH11, NEK6, NF1, NFKB1, NFKB2, NME1, NOTCH1, NTRK3, NUP214, NUP98, P2RY8, PAG1, PAICS, PAX5, PBX1, PDCD1, PDCD1LG2, PDGFRA, PDGFRB, PICALM, PIM1, PIM2, PML, PPAT, PRDM16, PRKAR2B, PTK2B, PTPN1, PYCR1, RAB29, RAG1, RAG2, RANBP1, RARA, RBM15, ROS1, RUNX1, RUNX1T1, S1PR2, SEMA6A, SERPINA9, SETD2, SH3BP5, SOX11, STIL, STRBP, TCF3, TFG, TLX1, TLX3, TNFRSF13B, TNFSF4, TP63, TYK2, WT1, and ZCCHC7

If testing for a single specific B-ALL gene fusion is desired, then Single Kinase Fusion Detection by Singleplex RT-PCR (Test Code: KINFS) is available.

SPECIMEN SHIPPING:

Specimen for this test must be shipped as soon as possible after collection due to time-sensitive specimen stability. Whenever possible, send specimen immediately after collection. If specimen cannot be sent on the collection date, then store the specimen in EDTA tube in a refrigerator overnight and ship out next day as soon as possible after transferring the specimen to COG ALL shipping media (if not available, use tissue culture or transport media or RPMI).

Bone marrow and Involved peripheral blood:

  • Sending from USA or Canada - For each specimen up to 5mL, transfer specimen collected in EDTA tube to a sterile container containing 2mL COG ALL shipping media. If COG ALL shipping media is not available, use 2mL tissue culture or tissue transport media. Ship via overnight priority courier at room temperature. Lab must receive specimen within 48 hours from collection time.
  • Sending from Other Countries - For each specimen up to 5mL, transfer specimen collected in EDTA tube to a sterile container containing 5mL COG ALL shipping media. If COG ALL shipping media is not available, use 5mL tissue culture or tissue transport media. Ship via overnight courier at room temperature. Lab must receive specimen within 48 hours from collection time.

Forms

Lab Form

CPT Code

  • 81455