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HelpTest Code MFCDF Myeloma, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Fixed Cell Pellet
Ordering Guidance
For the most complete genetic evaluation on fresh bone marrow specimens, order MSMRT/ Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow.
For evaluation of high-risk abnormalities, with reflex probes, on fresh bone marrow specimens that will be received within 96 hours of collection, order PCPDS / Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow. If the specimen received for this test is within 96 hours of collection, this test will be canceled and automatically reordered by the laboratory as PCPDS.
For testing paraffin-embedded tissue specimens from patients with a plasma cell disorder, order PLASF / Plasma Cell Proliferative Disorder, FISH, Tissue. If the specimen received for this test is paraffin-embedded, this test will be canceled and automatically reordered by the laboratory as PLASF.
Fresh bone marrow is only acceptable specimen for this test if the specimen will be received 96 hours or more post-collection.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A list of probes requested for analysis is required if select probes are necessary or if the patient is being tracked for known abnormalities. Probes available for this test are listed in the Testing Algorithm section.
2. A reason for testing must be provided. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
3. A flow cytometry and/or a bone marrow pathology report should be submitted with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.
Specimen Required
Container/Tube: Sterile container
Specimen Volume: 1 Fixed cell pellet
Collection Instructions: Place specimen in a sterile container with a 3:1 methanol:glacial acetic acid (or similar) fixative.
Useful For
Detecting, at diagnosis, recurrent high-risk common chromosome abnormalities associated multiple myeloma or other plasma cell proliferative disorders, when fresh bone marrow is unavailable, using a laboratory-designated probe set algorithm
Evaluating specimens in which the bone marrow is past 96 hours from collection
This test should not be used to track the progression of disease
Testing Algorithm
This test includes a charge for the probe application, analysis, and professional interpretation of results for 3 probe sets (6 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.
This test is designed for diagnostic bone marrow specimens from patients with multiple myeloma, or other plasma cell proliferative disorders, when either a fixed cell pellet or a bone marrow sample exceeding 96 hours post-collection is available. Best results are obtained when the bone marrow demonstrates at least 20% involvement by a plasma cell proliferative disorder.
This test is performed using either the diagnostic or follow-up analysis algorithm.
The diagnostic high-risk myeloma FISH panel includes testing for the following abnormalities using the FISH probes listed:
1p deletion/1q gain, CDKN2C/1q22 probe set
t(14q32;var) or IGH rearrangement, IGH break-apart probe set
-17/17p-, TP53/D17Z1 probe set
If an IGH rearrangement is identified, appropriate reflex testing will be performed in an attempt to identify the translocation partner using the FISH probes listed:
t(4;14)(p16.3;q32) IGH::FGFR3 fusion, FGFR3/IGH probe set
t(11;14)(q13;q32) or IGH::CCND1 fusion, CCND1/IGH probe set
t(14;16)(q32;q23) IGH::MAF fusion, IGH/MAF probe set
t(14;20)(q32;q12) IGH::MAFB fusion, IGH/MAFB probe set
Use of the follow-up analysis testing algorithm is determined by the results of either previous MFCDF / Myeloma, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Fixed Cell Pellet, PCPDS / Plasma Cell Proliferative Disorder, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow or MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow testing reported by this laboratory.
The follow-up high-risk myeloma FISH panel includes testing for the following abnormalities using the FISH probes listed:
1p deletion/1q gain, CDKN2C/1q22 probe set
t(8q24.21;var) or MYC rearrangement, MYC break-apart probe set
-17/17p-, TP53/D17Z1 probe set
Appropriate ancillary probes may be performed at consultant discretion to render comprehensive assessment. Any additional probes will have the results included within the final report and will be performed at an additional charge.
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
Myeloma Fixed Cell, High Risk, FISHSpecimen Type
Fixed Cell Pellet Bone MarrowSpecimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Fixed Cell Pellet Bone Marrow | Ambient (preferred) | |
| Refrigerated | ||
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming 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. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88271x6, 88275x3, 88291 x1-FISH Probe, Analysis, Interpretation; 3 probe sets
88271x2, 88275x1-FISH Probe, Analysis; each additional probe set (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MFCDF | Myeloma Fixed Cell, High Risk, FISH | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 614300 | Result Summary | 50397-9 |
| 614301 | Interpretation | 69965-2 |
| 614302 | Result Table | 93356-4 |
| 614303 | Result | 62356-1 |
| GC128 | Reason for Referral | 42349-1 |
| 614304 | Specimen | 31208-2 |
| 614305 | Source | 31208-2 |
| 614306 | Method | 85069-3 |
| 614307 | Additional Information | 48767-8 |
| 614308 | Disclaimer | 62364-5 |
| 614309 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.