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24744 Plasma Cell Proliferative Disorder FISH, Bone Marrow (PCPDF)

Plasma Cell Proliferative Disorder FISH, Bone Marrow (PCPDF)
Test Code: PCPDFSO
Synonyms/Keywords
+3/+7
+9/+15
13q- / -13 (13q deletion) or RB1
17p- (17p deletion) or TP53
-13 (monosomy 13)
IGH (14q32) rearrangement
Monoclonal Gammopathy of Unknown Significance (MGUS)
Multiple Myeloma
MYC (8q24.1) rearrangement
Plasma Cell Leukemia
t(4;14) - FGFR3/IGH
t(6;14) - CCND3/IGH
t(11;14) - CCND1/IGH
t(14;16) - IGH/MAF
t(14;20) - IGH/MAFB
+1q or 1q22
Useful For
Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders
 
Identifying prognostic markers based on the anomalies found
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Bone Marrow ​Sodium-heparin Green Top Tube (GTT) ​ ​3 mL ​1 mL ​
Collection Processing Instructions
Invert several times to mix bone marrow.
Specimen Stability Information
Specimen Type Temperature
​Bone Marrow ​ ​Ambient (preferred)
​Refrigerated
Rejection Criteria
No specimen should be rejected
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories
Monday through Friday
 7 days​
Cytoplasmic Immunoglobulin (cIg) Staining​ followed by Fluorescence In Situ Hybridization (FISH)
Reference Lab
Mayo Clinic Laboratories
Test Information
​
Multiple myeloma is a hematologic neoplasm that generally originates in the bone marrow and develops from malignant plasma cells. There are 4 main categories of plasma cell proliferative disorders (PCPDs): asymptomatic myeloma, smoldering myeloma, indolent myeloma, and multiple myeloma. Asymptomatic myeloma patients have nonspecific symptoms that may be attributed to other diseases. Generalized bone pain, anemia, numbness or limb weakness, symptoms of hypercalcemia, and recurrent infections are all symptoms that may indicate myeloma. In smoldering myeloma there is a monoclonal protein spike, but it is stable. Indolent myeloma is a slowly progressing myeloma.
 
As myeloma progresses, the malignant plasma cells interfere with normal blood product formation in the bone marrow resulting in anemia and leukopenia. Myeloma also causes an overstimulation of osteoclasts, causing excessive breakdown of bone tissue without the normal corresponding bone formation. These bone lesions are seen in approximately 66% of myeloma patients. In advanced disease, bone loss may reach a degree where the patient suffers fractures easily.
 
Multiple myeloma is increasingly recognized as a disease characterized by marked cytogenetic, molecular, and proliferative heterogeneity. This heterogeneity is manifested clinically by varying degrees of disease aggressiveness. Multiple myeloma patients with more aggressive disease experience suboptimal responses to some therapeutic approaches; therefore, identifying these patients is critically important for selecting appropriate treatment options.
Reference Range Information
An interpretive report will be provided.
Interpretation
This test is not approved by the FDA and is best used as an adjunct to existing clinical and pathologic information.
 
This test should not be used to track the progression of disease.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​​88291 ​ ​1 DNA probe, each (first probe set), Interpretation and report ​
​88271 ​ 2
DNA probe, each (first probe set), Interpretation and report
​88271 ​ 2 DNA probe, each; each additional probe set (if appropriate)
​88281 ​ ​1 ​DNA probe, each; coverage for sets containing 3 probes (if appropriate)
​88271 ​ ​2 ​​DNA probe, each; coverage for sets containing 4 probes (if appropriate)
​88271​ ​ ​3 ​DNA probe, each; coverage for sets containing 5 probes (if appropriate) ​
​​88274-52 ​ ​1 ​Interphase in situ hybridization, <25 cells, each probe set (if appropriate)
​88274​ ​ ​1 ​Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)
​88275​ ​ ​1 ​​Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)
Synonyms/Keywords
+3/+7
+9/+15
13q- / -13 (13q deletion) or RB1
17p- (17p deletion) or TP53
-13 (monosomy 13)
IGH (14q32) rearrangement
Monoclonal Gammopathy of Unknown Significance (MGUS)
Multiple Myeloma
MYC (8q24.1) rearrangement
Plasma Cell Leukemia
t(4;14) - FGFR3/IGH
t(6;14) - CCND3/IGH
t(11;14) - CCND1/IGH
t(14;16) - IGH/MAF
t(14;20) - IGH/MAFB
+1q or 1q22
Ordering Applications
Ordering Application Description
​Centricity ​Plasma Cell Prolif Disorder, FISH
​Cerner ​Plasma Cell Prolif Disorder, FISH (83358)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Bone Marrow ​Sodium-heparin Green Top Tube (GTT) ​ ​3 mL ​1 mL ​
Collection Processing
Invert several times to mix bone marrow.
Specimen Stability Information
Specimen Type Temperature
​Bone Marrow ​ ​Ambient (preferred)
​Refrigerated
Rejection Criteria
No specimen should be rejected
Useful For
Aiding in the diagnosis of new cases of multiple myeloma or other plasma cell proliferative disorders
 
Identifying prognostic markers based on the anomalies found
Reference Range Information
An interpretive report will be provided.
Interpretation
This test is not approved by the FDA and is best used as an adjunct to existing clinical and pathologic information.
 
This test should not be used to track the progression of disease.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories
Monday through Friday
 7 days​
Cytoplasmic Immunoglobulin (cIg) Staining​ followed by Fluorescence In Situ Hybridization (FISH)
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​​88291 ​ ​1 DNA probe, each (first probe set), Interpretation and report ​
​88271 ​ 2
DNA probe, each (first probe set), Interpretation and report
​88271 ​ 2 DNA probe, each; each additional probe set (if appropriate)
​88281 ​ ​1 ​DNA probe, each; coverage for sets containing 3 probes (if appropriate)
​88271 ​ ​2 ​​DNA probe, each; coverage for sets containing 4 probes (if appropriate)
​88271​ ​ ​3 ​DNA probe, each; coverage for sets containing 5 probes (if appropriate) ​
​​88274-52 ​ ​1 ​Interphase in situ hybridization, <25 cells, each probe set (if appropriate)
​88274​ ​ ​1 ​Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)
​88275​ ​ ​1 ​​Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)
For most current information refer to the Marshfield Laboratory online reference manual.