Test ID TALAF T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies
Ordering Guidance
This test is only performed on specimens from patients with T-cell acute lymphoblastic leukemia (T-ALL) who are 31 years and older.
This test is intended for instances when the entire T- ALL 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 TALPF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), 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 COGTF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Children's Oncology Group Enrollment Testing, FISH, Varies.
If limited T-cell ALL FISH probes are preferred, order TALMF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Specified FISH, Varies.
At follow-up, conventional cytogenetic studies (CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow) and targeted T-ALL FISH probes can be evaluated based on the abnormalities identified in the diagnostic study. Order TALMF / T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Specified FISH, Varies and request specific probes or abnormalities.
If the patient clinically relapses, a conventional chromosome study is useful to identify cytogenetic changes in the neoplastic clone or the possible emergence of a new therapy-related myeloid clone.
For patients with T-cell lymphoma, order TLPDF / T-Cell Lymphoma, Diagnostic FISH, Varies.
For testing paraffin-embedded tissue samples from patients with T-cell lymphoblastic lymphoma, order TLBLF / T-Lymphoblastic Leukemia/Lymphoma, FISH, Tissue. If a paraffin-embedded tissue sample is submitted for this test, testing will be canceled and TLBLF will be added and performed as the appropriate test.
Additional Testing Requirements
At diagnosis, conventional cytogenetic studies (CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow) and this FISH panel should be performed. If there is limited specimen available, only this test will be performed.
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 interpretation may be compromised or delayed. 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: 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 observed in adult patients with T-cell acute lymphoblastic leukemia (T-ALL)
An adjunct to conventional chromosome studies in patients with T-ALL
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 10 probe sets (20 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
If the patient clinically relapses, a conventional chromosome study is useful to identify cytogenetic changes in the neoplastic clone or the possible emergence of a new therapy-related myeloid clone.
The diagnostic adult T-cell acute lymphoblastic leukemia (T-ALL) FISH panel includes testing for the following abnormalities using the following FISH probes:
9p24.1 rearrangement, JAK2 break-apart
t(9;22) or ABL1 amplification, ABL1/BCR
11q23 rearrangement, MLL (KMT2A) break-apart
1p33 rearrangement, TAL1/STIL
t(5;14), TLX3/BCL11B fusion
7q34 rearrangement, TRB break-apart
14q11.2 rearrangement, TRAD break-apart
t(10;11), MLLT10/PICALM fusion
9q34 rearrangement, ABL1 break-apart
5q32 rearrangement, PDGFRB break-apart
When an MLL (KMT2A) rearrangement is identified, 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;19)(q23;p13.1) MLL/ELL
t(11;19)(q23;p13.3) MLL/MLLT1
When a TRAD rearrangement is identified, reflex testing will be performed to identify the translocation partner. Probes include identification of t(10;14)(q24;q11.2) TLX1/TRAD or t(11;14)(p13;q11.2) LMO2/TRAD.
When a TRB rearrangement is identified, reflex testing will be performed to identify the translocation partner. Probes include identification of t(7;10)(q34;q24) TRB/TLX1 or t(7;11)(q34;p13) TRB/LMO2.
For more information see Acute Leukemias of Ambiguous Lineage Testing Algorithm.
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
Adult ALL (T-cell), 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
88271x20, 88275x10, 88291x1-FISH Probe, Analysis, Interpretation; 10 probe sets
88271x2, 88275x1-FISH Probe, Analysis; each additional probe set (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
TALAF | Adult ALL (T-cell), FISH | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
609558 | Result Summary | 50397-9 |
609559 | Interpretation | 69965-2 |
609560 | Result Table | 93356-4 |
609561 | Result | 62356-1 |
GC071 | Reason for Referral | 42349-1 |
GC072 | Specimen | 31208-2 |
609562 | Source | 31208-2 |
609563 | Method | 85069-3 |
609564 | Additional Information | 48767-8 |
609565 | Disclaimer | 62364-5 |
609566 | Released By | 18771-6 |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
TALAB | Probe, Each Additional (TALAF) | No, (Bill Only) | No |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.