Detection of monoclonal B-cell populations in B-lymphoproliferative disorders
Performing Laboratory / Facility
UCLA Medical Center Clinical Laboratory (CHS)
Performing Section
Molecular Pathology
Availability
Monday through Friday, 0700-1700
Turnaround Time
14 days from receipt of specimen in performing lab
Methodology
Polymerase Chain Reaction (PCR) The IgH Gene Clonality Assay amplifies the DNA between primers that target the conserved framework (FR 1,2 and 3) and joining (J) region, and the diversity (D) and joining regions
Use
Heavy chain gene rearrangement is a useful marker of the clonality of B-lymphoproliferative disorders.
Limitations
Rearrangement will not be detected if the submitted tissue is not from the involved tumor. Some rearrangements may not be detectable due to the nature of the breakpoints. Some T-cell malignancies will show immunoglobulin gene rearrangements.
Additional Information
IgK will be performed if IgH is negative
Specimen Type
Whole Blood Bone Marrow Fresh Frozen Tissue FFPE Slides
Container
Whole Blood and Bone Marrow - Lavender/EDTA Tissue - Sterile Container or Sterile Container with RPMI
Collection Instructions
Tissue must be carefully cut from the surgically removed tumor and contain a representative sampling of at least 5% to 10% of tumor cells from the involved area.
Volume
Whole Blood - 4 mL Bone Marrow - 4 mL Fresh Frozen Tissue - 5mm3 FFPE Slides - 10 Unstained Slides + 1 H&E Slide
Minimum Volume
Whole Blood - 1 mL Bone Marrow - 1 mL
Storage Temperature
Fresh frozen tissue can be stored in a -70°C freeze
Special Instructions
When IGH is tested negative will proceed to test IGK
Shipping and Handling Instructions
Blood and bone marrow transport at room temperature. Fresh frozen tissue transport on dry ice.
Causes for Rejection
Tumor block containing insufficient tumor tissue, tumor tissue fixed in a heavy metal fixative (e.g. B-5 and Zenker's fixatives), Broken and stained slides.
Reference Range
No clonality observed
Test Information
CPT Codes
81261 81264
Synonyms
B-Cell IGH Heavy Chain Gene Clonality
B-Cell IGK Kappa Light chain Gene Clonality,
B-Lymphocyte Immunoglobulin
Heavy Chain Gene Rearrangement
Test Includes
Detection of monoclonal B-cell populations in B-lymphoproliferative disorders
Performing Laboratory / Facility
UCLA Medical Center Clinical Laboratory (CHS)
Performing Section
Molecular Pathology
Availability
Monday through Friday, 0700-1700
Turnaround Time
14 days from receipt of specimen in performing lab
Methodology
Polymerase Chain Reaction (PCR) The IgH Gene Clonality Assay amplifies the DNA between primers that target the conserved framework (FR 1,2 and 3) and joining (J) region, and the diversity (D) and joining regions
Use
Heavy chain gene rearrangement is a useful marker of the clonality of B-lymphoproliferative disorders.
Limitations
Rearrangement will not be detected if the submitted tissue is not from the involved tumor. Some rearrangements may not be detectable due to the nature of the breakpoints. Some T-cell malignancies will show immunoglobulin gene rearrangements.
Additional Information
IgK will be performed if IgH is negative
Specimen Collection and Handling
Specimen Type
Whole Blood Bone Marrow Fresh Frozen Tissue FFPE Slides
Container
Whole Blood and Bone Marrow - Lavender/EDTA Tissue - Sterile Container or Sterile Container with RPMI
Collection Instructions
Tissue must be carefully cut from the surgically removed tumor and contain a representative sampling of at least 5% to 10% of tumor cells from the involved area.
Volume
Whole Blood - 4 mL Bone Marrow - 4 mL Fresh Frozen Tissue - 5mm3 FFPE Slides - 10 Unstained Slides + 1 H&E Slide
Minimum Volume
Whole Blood - 1 mL Bone Marrow - 1 mL
Storage Temperature
Fresh frozen tissue can be stored in a -70°C freeze
Special Instructions
When IGH is tested negative will proceed to test IGK
Shipping and Handling Instructions
Blood and bone marrow transport at room temperature. Fresh frozen tissue transport on dry ice.
Causes for Rejection
Tumor block containing insufficient tumor tissue, tumor tissue fixed in a heavy metal fixative (e.g. B-5 and Zenker's fixatives), Broken and stained slides.
