Fish Analysis, PML/RARA Translocation

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FISH ANALYSIS, PML/RARA TRANSLOCATION

Pseudonyms: t(15;17); 15;17 Translocation; PML-RARA Translocation; PML/RARA Fusion; PML-RARα Translocation; PML-RARα Fusion; Acute Promyelocytic Leukemia; APL; AML M3

TURNAROUND TIME: 2 days for diagnostic sample. 10 days for minimal residual disease assessment.
 
 
TESTING METHODOLOGY: Fluorescence in situ hybridization
 
SPECIMEN REQUIREMENTS:
  • Collect: 2 mL bone marrow aspirate in sodium heparin (green); 5 mL peripheral blood in sodium heparin (green) also acceptable
  • Minimum Collection: 1 mL bone marrow or 2 mL peripheral blood
  • Transport: bone marrow or peripheral blood in sodium heparin (green) at 20-25°C; specimen should arrive in the laboratory within 24 hours of collection
  • Stability: Ambient: 24 hours; Refrigerated: 24 hours; Frozen: unacceptable
  • Unacceptable Conditions: Frozen or clotted specimens; paraffin-embedded specimens; specimens in anticoagulants other than sodium heparin.
A Cytogenetics/FISH Laboratory Test Requisition must accompany the specimen. Contact the Cytogenetics Laboratory at 918-502-1722 to obtain further information.
 
INTERPRETIVE DATA:
 
Test Summary: Test can detect the 15;17 translocation characteristic of acute promyelocytic leukemia (APL); for diagnostic specimens, it is recommended that test be performed with chromosome analysis
 
 
Methods: A dual-color dual-fusion FISH analysis performed on interphase cells using a probe for the PML gene on chromosome 15q22 and a probe for the RAR-alpha gene on chromosome 17q21; analysis of 200 interphase cells; analysis of 500 interphase cells for minimal residual disease assessment
 
Interpretation: A positive result (PML-RARA fusion) is reported when the percent of cells with an abnormality exceeds the normal reference range for the probes. The detection of an abnormal clone indicates a diagnosis of APL with the 15;17 translocation. A negative result indicates no 15;17 translocation was observed but does not rule out the presence of a neoplastic disorder.
 
FDA Approval: This test is not approved by the FDA and it should be used as an adjunct to clinical and pathological information.
 
Indications for Use:
  • Establishing the diagnosis of APL
  • Monitoring the 15;17 translocation (PML-RARA fusion) during treatment
  • Detecting residual disease in patients with the 15;17 translocation