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

Plasma Cell Proliferative Disorder FISH, Bone Marrow (PCPDS)
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
 
This test SHOULD NOT BE USED to track the progression of the disease
 
Advisory Information:
This assay detects abnormalities observed in the bone marrow of patients with a plasma cell disorder.
-For paraffin-embedded tissue specimens, order PLASF / Plasma Cell Proliferative Disorder, FISH, Tissue.
-For fixed cell pellet specimens, order MFCF / Myeloma, FISH, Fixed Cells.
-Testing will be changed to the appropriate test if this test is ordered on either of the previous specimens or if bone
marrow specimens are received >96 hours from collection.
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 Heparin Green top tube (GTT)

​EDTA Lavender top tube (LTT)

ACD Yellow top tube (YTT)

​4 mL ​2 mL
Collection Processing Instructions
Invert several times to mix bone marrow.
 
Necessary Information:
1. Provide a reason for referral 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.
2. A pathology and/or flow cytometry report may be requested to optimize testing and aid in interpretation of results.
Specimen Stability Information
Specimen Type Temperature​Time
​Bone Marrow ​ ​Ambient (preferred)​4 days
​Refrigerated​4 days
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​
Fluorescence In Situ Hybridization (FISH)
Reference Lab
Test Information

Multiple myeloma is a hematologic neoplasm that generally originates in the bone marrow and develops from malignant plasma cells. There are four main categories of plasma cell proliferative disorders (PCPD): monoclonal gammopathy of undetermined significance (MGUS), monoclonal immunoglobulin deposition diseases (amyloidosis), plasmacytoma, and multiple myeloma. MGUS, which occurs in 3% to 4% of individuals over age 50 years, represents the identification of an asymptomatic monoclonal protein, yet approximately 1% per year will progress to multiple myeloma. Amyloidosis represents a rare group of deposition disorders including primary amyloidosis vs. light chain and heavy chain disease. Plasmacytomas represent isolated collections of bone or extramedullary plasma cells with a risk for development of multiple myeloma. Generalized bone pain, anemia, limb numbness or weakness, symptoms of hypercalcemia, and recurrent infections are all symptoms that may indicate multiple 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
​88184​1​Flow Cytometry/TC 1 Marker
​88185​5​Flow Cytometry/TC Add-on
​88271 2 DNA probe, each; each additional probe set (if appropriate)
​88271 ​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 ​PCPD, FISH (PCPDS)
​Cerner ​Plasma Cell Proliferative Disorder, FISH (PCPDS)
​COM​Plasma Cell Prolif, FISH
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 Heparin Green top tube (GTT)

​EDTA Lavender top tube (LTT)

ACD Yellow top tube (YTT)

​4 mL ​2 mL
Collection Processing
Invert several times to mix bone marrow.
 
Necessary Information:
1. Provide a reason for referral 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.
2. A pathology and/or flow cytometry report may be requested to optimize testing and aid in interpretation of results.
Specimen Stability Information
Specimen Type Temperature​Time
​Bone Marrow ​ ​Ambient (preferred)​4 days
​Refrigerated​4 days
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
 
This test SHOULD NOT BE USED to track the progression of the disease
 
Advisory Information:
This assay detects abnormalities observed in the bone marrow of patients with a plasma cell disorder.
-For paraffin-embedded tissue specimens, order PLASF / Plasma Cell Proliferative Disorder, FISH, Tissue.
-For fixed cell pellet specimens, order MFCF / Myeloma, FISH, Fixed Cells.
-Testing will be changed to the appropriate test if this test is ordered on either of the previous specimens or if bone
marrow specimens are received >96 hours from collection.
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​
Fluorescence In Situ Hybridization (FISH)
Reference Lab
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
​88184​1​Flow Cytometry/TC 1 Marker
​88185​5​Flow Cytometry/TC Add-on
​88271 2 DNA probe, each; each additional probe set (if appropriate)
​88271 ​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.