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Test Code LPLFX Lymphoplasmacytic Lymphoma/Waldenstrom Macroglobulinemia (LPL/WM), MYD88 L265P with Reflex to CXCR4, Varies


Shipping Instructions


Peripheral blood or bone marrow specimens must arrive within 10 days of collection.



Necessary Information


The following information is required:

1. Pertinent clinical history

2. Clinical or morphologic suspicion

3. Date and time of collection

4. Specimen source



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

 

Specimen Type: Bone marrow

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD solution B)

Specimen Volume: 2 mL

 

Collection Instructions:

1. Invert several times to mix bone marrow

2. Send specimen in original tube

3. Label specimen as bone marrow

Specimen Stability Information: Ambient (preferred)/Refrigerated

 

Specimen Type: Paraffin-embedded tissue

Container/Tube: Paraffin block

Specimen Stability: Ambient

 

Specimen Type: Paraffin-embedded bone marrow aspirate clot

Container/Tube: Paraffin block

Specimen Stability: Ambient

 

Specimen Type: Tissue

Slides: Unstained slides

Specimen Volume: 10 slides

Additional Information: Tissue must demonstrate involvement by a hematologic neoplasm (eg, acute myelocytic leukemia), not solid tumors.

Specimen Stability Information: Ambient

 

Acceptable:

 

Specimen Type: Peripheral blood

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD solution B)

Specimen Volume: 3 mL

Collection Instructions:

1. Invert several times to mix blood

2. Send specimen in original tube

3. Label specimen as blood

Specimen Stability Information: Ambient (preferred)/Refrigerated

 

Specimen Type: Extracted DNA

Container/Tube: 1.5- to 2-mL tube with indication of volume and concentration of the DNA

Specimen Volume: Entire specimen

Collection Instructions: Label specimen as extracted DNA and list the specimen source.  Include indication of volume and concentration of the DNA.

Specimen Stability Information: Frozen (preferred)/Refrigerated/Ambient


Forms

1. Hematopathology Patient Information (T676) in Special Instructions

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

Useful For

Establishing the diagnosis of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (LPL/WM)

 

Helping distinguish LPL/WM low-grade B-cell lymphoma from other subtypes

 

Aiding in the prognostication and clinical management of LPL/WM

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
CXCFX CXCR4, Gene Mutation, Reflex No, (bill only) No

Testing Algorithm

The algorithm starts with the sensitive MYD88 L265P testing by allele-specific polymerase chain reaction (PCR.) If a MYD88 L265P variant is detected, additional CXCR4 testing will be performed. If a MYD88 L265P variant is not detected, the algorithm ends and no further testing is necessary.

Method Name

Allele-Specific Polymerase Chain Reaction (AS-PCR), Bridged Nucleic Acids (BNA) Clamp Sanger Sequencing and Routine Sanger Sequencing

(BNAClamp is utilized pursuant to a license agreement with BNA Inc.)

Reporting Name

Reflex Testing of MYD88 and CXCR4

Specimen Type

Varies

Specimen Minimum Volume

Blood, Bone marrow: 1 mL
Extracted DNA: 20 mcL with a concentration of at least 10 nanograms per mcL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies 10 days

Reject Due To

Gross hemolysis Reject
Other B5-fixed tissues Decalcified bone marrow biopsies Methanol-acetic acid (MAA)-fixed pellets Paraffin shavings Frozen tissue Moderately to severely clotted

Reference Values

MYD88 L265P: Variant present or absent based on expected variant PCR product size for the MYD88 gene (NCBI accession NM_002468.4).

 

CXCR4: Variants present or absent in the test region c. 898-1059 (amino acids 300-353) of the CXCR4 gene (NCBI NM_003467.2, GRCh37).

Day(s) and Time(s) Performed

Monday through Friday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

81305

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LPLFX Reflex Testing of MYD88 and CXCR4 82140-5

 

Result ID Test Result Name Result LOINC Value
MP042 Specimen Type 31208-2
601511 LPLFX Reflex Result 82140-5
601510 Final Diagnosis 50398-7