Test ID AMLAF Acute Myeloid Leukemia (AML), FISH, Adult, Varies
Ordering Guidance
This test is only performed on specimens from patients with acute myeloid leukemia (AML) who are 31 years of age or older.
This test is intended for instances when the entire AML fluorescence in situ hybridization (FISH) panel is needed for an adult patient.
-If this test is ordered on a patient 30 years of age or younger, this test will be canceled and automatically reordered by the laboratory as AMLPF / Acute Myeloid Leukemia (AML), FISH, Pediatric, Varies.
- If this test is ordered and the laboratory is informed that the patient is on a Children's Oncology Group (COG) protocol, this test will be canceled and automatically reordered by the laboratory as COGMF / Acute Myeloid Leukemia (AML), Children's Oncology Group Enrollment Testing, FISH, Varies.
This test should not be used to screen for residual acute myeloid leukemia (AML). If the patient is being treated for known abnormalities or if limited AML FISH probes are preferred, order AMLMF / Acute Myeloid Leukemia (AML), Specified FISH, Varies and request specific probes or abnormalities.
At follow-up, targeted AML FISH probes can be evaluated based on the specific abnormalities identified in the diagnostic study. Order AMLMF and request specific probes or abnormalities.
For testing paraffin embedded tissue samples from patients with myeloid sarcoma, order MSTF / Myeloid Sarcoma, FISH, Tissue.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
A reason for testing and a flow cytometry and/or a bone marrow pathology report should be submitted with each specimen. The laboratory will not reject testing if this information is not provided; however, appropriate testing and/or interpretation may be compromised or delayed in some instances. If not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Bone marrow
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 2 to 3 mL
Collection Instructions:
1. It is preferable to send the first aspirate from the bone marrow collection.
2. Invert several times to mix bone marrow.
3. Send bone marrow in original tube. Do not aliquot.
Specimen Type: Blood
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood in original tube. Do not aliquot.
Useful For
Detecting a neoplastic clone associated with recurrent chromosome abnormalities seen in adult patients with acute myeloid leukemia (AML) or other myeloid malignancies
An adjunct to conventional chromosome studies in patients with AML
Evaluating specimens in which standard cytogenetic analysis is unsuccessful
This test should not be used to screen for residual AML.
Testing Algorithm
This test includes a charge for the probe application, analysis, and professional interpretation of results for 4 probe sets (8 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
The initial panel includes testing for the following abnormalities using the probes listed:
-inv(16), [M4, Eos], MYH11/CBFB
-t(8;21), [M2], RUNX1T1/RUNX1
-t(15;17), [M3], PML/RARA
-11q23 rearrangement, [M0-M7], MLL (KMT2A)
If testing was ordered concurrently with a chromosomal study (CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow or CHRHB / Chromosome Analysis, Hematologic Disorders, Blood), secondary testing will not be performed. Appropriate secondary FISH probes will be recommended if the chromosome results are informative.
Based on the results from the initial panel, the following secondary panel of FISH probes will be performed, when appropriate, if testing was NOT ordered concurrently with a chromosomal study.
-t(6;9), [M2,M4], DEK/NUP214
-inv(3) or t(3;3), [M1,2,4,6,7], RPN1/MECOM
-5/5q-, D5S630/EGR1
-7/7q-, D7Z1/D7S486
-17p-, TP53/D17Z1
-t(9;22), ABL1/BCR
When an MLL (KMT2A) rearrangement is identified, appropriate reflex testing will be performed to identify the translocation partner. Probes include identification of t(4;11)(q21;q23) AFF1/MLL, t(6;11)(q27;q23) MLLT4(AFDN)/MLL, t(9;11)(p22;q23) MLLT3/MLL, t(10;11)(p12;q23) MLLT10/MLL, t(11;16)(q23;p13.3) MLL/CREBBP, t(11;19)(q23;p13.1) MLL/ELL or t(11;19)(q23;p13.3) MLL/MLLT1. In the event an 11q23 translocation is identified by conventional chromosome analysis, only the targeted MLL reflex probe will be performed if applicable.
In the absence of RPN1/MECOM and RUNX1/RUNX1T1 fusion, when an extra MECOM signal and an extra RUNX1 signal are identified, reflex testing using the MECOM/RUNX1 probe set will be considered at the laboratory's discretion to identify a potential t(3;21)(q26.2;q22) rearrangement. Laboratory discretion may be influenced by available karyotype results.
In the absence of RPN1/MECOM fusion, when an extra RPN1 signal is identified, reflex testing using the PRDM16/RPN1 probe set will be considered at the laboratory's discretion to identify a potential t(1;3)(p36;q21). Laboratory discretion may be influenced by available karyotype results.
In the absence of MYH11/CBFB fusion, when an extra CBFB signal is identified, reflex testing may be performed at the laboratory's discretion using the CBFB break-apart probe set to evaluate for the presence or absence of an CBFB rearrangement. Laboratory discretion may be influenced by available karyotype results.
In the absence of PML/RARA fusion, when an extra or atypical RARA signal is identified, testing using the 5'RARA/3'RARA rearrangement probe set may be performed at the laboratory's discretion to identify a potential variant translocation involving RARA. example: t(17;var)(q21;?). Laboratory discretion may be influenced by available karyotype results.
In the absence of BCR/ABL1 fusion, when an extra ABL1 signal is identified, reflex testing may be performed at the laboratory's discretion using the ABL1 break-apart probe set to evaluate for the presence or absence of an ABL1 rearrangement. Laboratory discretion may be influenced by available karyotype results.
The following algorithms are available:
Acute Promyelocytic Leukemia: Guideline to Diagnosis and Follow-up
Special Instructions
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
Adult AML, FISHSpecimen Type
VariesSpecimen Minimum Volume
Blood: 2 mL
Bone Marrow: 1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Ambient (preferred) | ||
Refrigerated |
Reference Values
An interpretive report will be provided.
Day(s) Performed
Monday through Friday
Report Available
7 to 10 daysPerforming Laboratory

Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
88271 x 8, 88275 x 4, 88291-FISH Probe, Analysis, Interpretation; 4 probe sets
88271 x 2, 88275 FISH Probe, Analysis; each additional probe set (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
AMLAF | Adult AML, FISH | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
609518 | Result Summary | 50397-9 |
609519 | Interpretation | 69965-2 |
609520 | Result Table | 93356-4 |
609521 | Result | 62356-1 |
GC059 | Reason for Referral | 42349-1 |
GC060 | Specimen | 31208-2 |
609522 | Source | 31208-2 |
609523 | Method | 85069-3 |
609524 | Additional Information | 48767-8 |
609525 | Disclaimer | 62364-5 |
609526 | Released By | 18771-6 |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
AMLAB | Probe, Each Additional (AMLAF) | No, (Bill Only) | No |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.