Test ID BALMF B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Specified FISH, Varies
Ordering Guidance
This test is intended for instances when targeted B-cell acute lymphoblastic leukemia/lymphoma (B-ALL/LBL) fluorescence in situ hybridization (FISH) probes are needed based on specific abnormalities or abnormalities identified in the diagnostic sample. The FISH probes to be analyzed must be specified on the request, otherwise test processing may be delayed in order to determine the intended analysis.
-If specific probes are not included with this test request, the test may be canceled and automatically reordered by the laboratory as BALAF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or BALPF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies depending on the age of the patient.
-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 COGBF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Children's Oncology Group Enrollment Testing, FISH, Varies.
For an adult patient, if the entire B-cell ALL FISH panel is preferred, order BALAF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies.
For a pediatric patient, if the entire B-cell ALL FISH panel is preferred, order BALPF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies.
At diagnosis, both conventional cytogenetic studies (CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow) and either BALAF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies or BALPF / B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies should be performed.
If the patient clinically relapses, a conventional chromosome study may be useful to identify cytogenetic changes in the neoplastic clone or the possible emergence of a therapy-related myeloid clone.
For patients with B-cell lymphoma, order BLPMF / B-Cell Lymphoma, Specified FISH, Varies.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. A list of probes requested for analysis is required. Probes available for this test are listed in the Testing Algorithm section.
2. 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 specimen in original tube. Do not aliquot.
Acceptable
Specimen Type: Whole 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 specimen in original tube. Do not aliquot.
Useful For
Detecting a neoplastic clone associated with the common chromosome abnormalities and classic rearrangements seen in patients with B-cell acute lymphoblastic leukemia/lymphoma (B-ALL/LBL) using client specified probes
An adjunct to conventional chromosome studies for patients with B-ALL/LBL
Evaluating specimens in which standard cytogenetic analysis is unsuccessful
Testing Algorithm
This test includes a charge for the probe application, analysis, and professional interpretation of results for 1 probe set (2 individual fluorescence in situ hybridization [FISH] probes or 3 individual FISH probes). Additional charges will be incurred for all reflex or additional probe sets performed.
If the patient is being treated for known abnormalities, indicate the abnormality and which probes should be used.
When specified, any of the following probes will be performed:
1q25 rearrangement, ABL2 break-apart
5q32 rearrangement, PDGFRB break-apart
7p-, IKZF1/CEP7
9p24.1 rearrangement, JAK2 break-apart
+9/9p-, CDKN2A/D9Z1
t(9;22) BCR/ABL1
9q34 rearrangement, ABL1 break-apart
11q23 rearrangement, MLL (KMT2A) break-apart
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)(p13;q23), MLLT10/MLL
t(11;19)(q23;p13.1), MLL/ELL
t(11;19)(q23;p13.3), MLL/MLLT1
-17/17p-, TP53/D17Z1
t(1;19)(q23;p13), PBX1/TCF3
Hyperdiploidy, +4,+10,+17: D4Z1/D10Z1/D17Z1
t(12;21)(p13;q22), ETV6/RUNX1 & iAMP21
12p13 rearrangement, ETV6 break-apart
14q32 rearrangement, IGH break-apart
t(Xp22.33;var) or t(Yp11.32;var), P2RY8 rearrangement
t(Xp22.33;var) or t(Yp11.32;var), CRLF2 rearrangement
t(X;14)(p22.33;q32) or t(Y;14)(p11.32;q32) ), CRLF2/IGH
8q24.1 rearrangement, MYC break-apart
For more information, see B-Lymphoblastic Leukemia/Lymphoma Algorithm.
Special Instructions
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
ALL (B-cell), Specified 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 x2, 88275 x1, 88291 x1- FISH Probe, Analysis, Interpretation; 1 probe sets
88271 x2, 88275 x1 - FISH Probe, Analysis; each additional probe set (if appropriate)
88271 x1 –-FISH Probe; coverage for sets containing 3 probes (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
BALMF | ALL (B-cell), Specified FISH | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
614217 | Result Summary | 50397-9 |
614218 | Interpretation | 69965-2 |
614219 | Result Table | 93356-4 |
614220 | Result | 62356-1 |
GC101 | Reason for Referral | 42349-1 |
GC102 | Probes Requested | 78040-3 |
GC103 | Specimen | 31208-2 |
614221 | Source | 31208-2 |
614222 | Method | 85069-3 |
614223 | Additional Information | 48767-8 |
614224 | Disclaimer | 62364-5 |
614225 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.