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Multiple Myeloma Enriched Microarray and Multiple Myeloma FISH

CPT 81277
Synonyms
  • Monoclonal Gammopathy of Undetermined Significance (MGUS)
  • Oncology Array
  • Plasma Cell Leukemia
  • Reveal® MM Enrich CMA

Test Details

Turnaround Time

10 - 14 days

Use

This test is a diagnostic test for multiple myeloma. Plasma cell enrichment diagnosis increased as much as 50% to 100%. The FISH results on the enriched assay should not be used as a quantitative assay, since the abnormal cells do not represent the percentage of abnormal cells in the aspirate. The SNP assay will detect chromosomal imbalance that may be present in neoplastic disorders and clonal evolution. It provides detection of copy-neutral loss of heterozygosity of any chromosome, and the percent and location of homozygosity, that may be associated with cancer gene mutations.

Special Instructions

Indicate pertinent clinical diagnosis and previous cytogenetics studies on the test request form.

Test Includes

Fluorescence in situ hybridization (FISH) for multiple myeloma (MM); IgH-CCDN1; FGFR3/IgH; CMAF/IgH; SNP microarray (Reveal®)

Limitations

The SNP assay does not detect balanced rearrangements, low-level mosaicism (<10%), marker chromosomes that only contain heterochromatin or tetraploidy.

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

Methodology

Fluorescence in situ hybridization (FISH) and plasma cell enrichment. SNP microarray analysis is performed using the Cytoscan® HD platform, which uses more than 743,000 SNP probes and 1,953,000 NPCN probes with a median spacing of 0.88 kb.

References

Fonseca R, Barlogie B, Bataille R, et al. Genetics and cytogenetics of multiple myeloma: A workshop report. Cancer Res. 2004 Feb 15;64:1546-1558.14989251
Fonseca R, Bergsagel PL, Drach J, et al. International Myeloma Working Group molecular classification of multiple myeloma: Spotlight review. Leukemia. 2009 Dec;23(12):2210-2221.19798094
Pozdnyakova O, Crowley-Larsen P, Zota V, Wang SA, Miron PM. Interphase FISH in plasma cell dyscrasia: Increased in abnormality detection with plasma cell enrichment. Cancer Genet Cytogenet. 2009 Mar;189(2):112-117.19215792

Specimen Requirements

Information on collection, storage, and volume

Specimen

Bone marrow

Volume

1 to 3 mL bone marrow

Minimum Volume

1 mL bone marrow (Note: This volume may not allow for repeat testing.)

Container

Green-top (sodium heparin) tube; pediatric Vacutainer® is optimal or lavender-top (EDTA) tube (suboptimal). For samples with shared karyotype (510999) and any FISH study in the same tube, EDTA is not recommended due to the growth inhibition in cell culture. Adjust tube size to sample volume to avoid heparin toxicity.

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Whole blood; broken tube; for SNP microarray, quantity not sufficient for analysis, gel-separator tubes, microtainer tubes, fixed cell pellets

Collection

Utilize sterile technique and Labcorp transport kits when possible.