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Test ID MYEFL Myelodysplastic Syndrome by Flow Cytometry, Bone Marrow

Useful For

Detecting increased blasts

 

Characterizing blast phenotypes

 

Identifying abnormal patterns of myeloid maturation as seen in myelodysplastic syndromes and other clonal myeloid neoplasms

 

Providing additional adjunct diagnostic information in cases with equivocal or suspicious morphologic features for myelodysplastic syndrome (MDS), MDS/myeloproliferative neoplasms including chronic myelomonocytic leukemia, and other clonal myeloid neoplasms

Highlights

This assay, when used in combination with appropriate review of the clinical history, morphologic, cytogenetic, and molecular genetic data, may provide helpful diagnostic information in evaluating bone marrow specimens for possible involvement by a myelodysplastic syndrome (MDS) or a myelodysplastic/myeloproliferative neoplasm (MDS/MPN) including chronic myelomonocytic leukemia (CMML).

 

In addition to detecting increased blasts, this assay also analyzes blast phenotypes and patterns of myeloid maturation. The diagnostic contribution of this assay, thus, does not rely solely on identifying blast increases.

 

This assay is not intended for prognostication or monitoring of response to therapy.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
FCINS Flow Cytometry Interp,16 or greater No, (Bill Only) No

Testing Algorithm

This assay uses 2 panels for identifying cell populations of interest and for characterizing their phenotypic features. In the myelodysplastic syndrome panel, blasts are identified by CD45/side scatter gating strategy and by CD34 expression; promyelocytes are identified by bright CD13, CD33, and CD117 expression without CD34; granulocytes and precursors are defined by their variable expression of CD13 and CD16 according to their maturational stages. Abnormal patterns of myeloid maturation are determined according to the presence or absence of the following features: distinct blast increases over 5%; heterogeneous blast distribution on CD13/HLA-DR plot; expression of CD2, CD7, and/or CD56 on blasts; and disrupted granulocytic maturation on CD13/CD16 plot.(1,2)

 

Additionally, a triage panel is performed to ensure that monotypic B-cells, increased plasma cells, and phenotypically aberrant populations of CD3-positive T-cells and CD16-positive/CD3-negative natural killer (NK) cells, if present, are identified. This is necessary especially for cases where the reason for referral is broad, where clonal myeloid neoplasms may not be the only diagnostic consideration, or where there is incomplete clinical history and morphologic data.

 

These panels are used in combination with any available provided clinical history and morphologic findings to determine if any additional testing may be needed for complete disease characterization. If such additional testing is required, it will be added according to laboratory algorithms at an additional charge per unique antibody tested.

Reporting Name

MDS by Flow Cytometry, BM

Specimen Type

Bone Marrow


Additional Testing Requirements


If cytogenetic tests are also desired when collecting MYEFL / Myelodysplastic Syndrome by Flow Cytometry, Bone Marrow, an additional specimen should be submitted. It is important that the specimen be obtained, processed, and transported according to instructions for the other required test.



Shipping Instructions


Specimen must be received within 72 hours.



Specimen Required


Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Heparin, EDTA

Specimen Volume: 2-5 mL

Slides: Include 5 to 10 unstained bone marrow aspirate smears, if possible.

Collection Instructions:

1. Submission of bilateral specimens is not required.

2. Label specimen as bone marrow.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Bone Marrow Ambient

Reference Values

An interpretive report will be provided. This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and, if available, morphologic features will be provided by a board-certified hematopathologist for every case.

Day(s) and Time(s) Performed

Specimens are processed and reported Monday through Saturday.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were 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

88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1

88185-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each) x18

88189-Flow Cytometry Interpretation, 16 or More Markers (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MYEFL MDS by Flow Cytometry, BM In Process

 

Result ID Test Result Name Result LOINC Value
CK086 MDS Panel No LOINC Needed
CK092 Final Diagnosis 22637-3
CK093 Special Studies 30954-2
CK094 Microscopic Description 22635-7

NY State Approved

Yes

Method Name

Immunophenotyping

Additional Tests

Test ID Reporting Name Available Separately Always Performed
ADD1 Flow Cytometry, Cell Surface, Addl No, (Bill Only) Yes
FIRST Flow Cytometry, Cell Surface, First No, (Bill only) Yes

Forms

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