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MYD88, L265, Somatic Gene Mutation, DNA Allele-Specific PCR, Varies (MYD88), MYD88, L265P, B-cell lymphoma, LPL/WM, Lymphoplasmacytic lymphoma, Waldenstrom's macroglobulinemia
Establishing the diagnosis of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia
Helping to distinguish lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (low-grade B-cell lymphoma) from other subtypes
Yellow Top (ACD solution B)
Green Top Tube (Heparin)
Yellow Top (ACD solution b)
Submit only 1 of the above specimens.
Peripheral blood or bone marrow specimens must arrive within 10 days (240 hours) of collection.
The following information is required:
-Pertinent clinical history
-Clinical or morphologic suspicion
-Date of collection
Collection Instructions for Bone Marrow:
1. Invert several times to mix bone marrow.
2. Send specimen in original tube. Do not aliquot.
3. Label specimen as bone marrow.
Specimen Stability: Ambient (preferred)/Refrigerated
Paraffin-embedded tissue and Paraffin-embedded bone marrow aspirate clot stability: Ambient
Collection Instructions for Peripheral blood:
1. Invert several times to mix blood.
3. Label specimen as blood.
Collection Instructions for Frozen tissue:
1. Freeze tissue within 1 hour of collection.
Specimen Stability: Frozen
Unstained slides stability: Ambient
Collection Instructions for Extracted DNA:
1. Label specimen as extracted DNA and source of specimen.
2. Indicate volume and concentration of the DNA on the label.
Specimen Stability: Frozen (preferred)/Refrigerated
Methanol-acetic acid (MAA) fixed pellets stability: Ambient (preferred)/Refrigerated
This test is a targeted assay and will not detect any alteration at the MYD88 codon 265 that does not result in the L>P (leucine to proline) amino acid change. It will also not detect additional MYD88 alterations, including insertion or deletion events. The analytical sensitivity of the assay (1% MYD88 L265P in a wild-type background) can be affected by a variety of factors, including biologic availability (ie, tumor burden), fixation of paraffin-embedded specimens, or nonspecific polymerase chain reaction interferences. Rare cases of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (LPL/WM) have been reported lacking the MYD88 L265P abnormality, so a negative result would not completely exclude this diagnosis but would make the possibility of LPL/WM more unlikely.
The single point alteration in MYD88, L265P, is present in 67% to 100% of patients with lymphoplasmacytic lymphoma, and these patients typically have clinical manifestations of Waldenstrom macroglobulinemia (often designated LPL/WM).
Variant present or not detected; an interpretive report will be issued.