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Laboratory Test Directory

Targeted B-ALL Fusion Analysis (Updated)

Components

Name Method Department Units
Targeted B-ALL Fusion Analysis Next Generation Sequencing (NGS)
Anchored Multiplex PCR (AMP)
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 lab on ice immediately after collection

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

RNA

Container Type Container Size Specimen Volume
Preferred

Sterile container

1.5 mL 150 ng
Stability

Frozen - 72 hour(s)

Specimen Preparation

  • DNA/RNA samples must be extracted by CLIA/CAP-certified or equivalent lab
  • Keep frozen
  • Immediately place on dry ice and transport frozen
  • Wrap specimen container tightly with parafilm
  • Must accompany cytospin slide from the exact sample used to extract DNA/RNA

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 Pediatric Oncology Test Requisition Form. Submission of a completed Test Requisition Form is required, and submission of informed consent form is recommended (but not required).

This test requires a bone marrow or blood sample containing a minimum of 10% blasts. If internal pathology review determines that the sample contains less than 10% blasts, then the test may be cancelled.

This test is designed for patients suspected to have a subtype of B-progenitor acute lymphoblastic leukemia (B-ALL) called Philadelphia chromosome-like B-ALL, which is seen in about 15% of children with newly diagnosed and/or relapsed B-ALL and is characterized by a gene expression profile suggestive of an alternate kinase gene fusion in the absence of a classical t(9;22) BCR-ABL1 rearrangement seen in Philadelphia (Ph) chromosome-positive leukemias.

This test detects gene fusions that have the following kinase genes as the 3' fusion partner: ABL1, ABL2, BLNK, CSF1R, EPOR, FGFR1, FLT3, JAK2, NTRK3, PDGFRA, PDGFRB, PTK2B and TYK2. In addition, this test will also detect some, but not all, IGH-CRLF2 gene fusion. All positive fusion results from this test will be confirmed using singleplex RT-PCR with bi-directional Sanger sequencing. 

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.

RNA specimen and Cytospin slide: Only the RNA sample extracted in CLIA-certified lab can be accepted, and RNA must accompany a cytospin slide from the exact same specimen used for RNA extraction. Without the cytospin slide, RNA specimen cannot be accepted. Send RNA specimen in sterile container. Wrap parafilm tightly around the container cap. Surround the RNA container in dry ice and ship frozen by overnight courier. Send Cytospin slide at room temperature. Specimen must stay frozen during the entire transport ?ensure sufficient dry ice is enclosed and the sample is completely buried in dry ice.

Forms

Lab Form

CPT Code

  • 81450