Test ID TALPF T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies
Ordering Guidance
This test is intended for instances when the entire T-ALL fluorescence in situ hybridization (FISH) panel is needed for a pediatric patient.
-If this test is ordered on a patient older than 30 years, this test will be canceled and automatically reordered by the laboratory as TALAF/ T-Cell Acute Lymphoblastic Leukemia/Lymphoma, FISH, Adult, 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-Cell Lymphoblastic Leukemia/Lymphoma, FISH, Tissue.
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 FISH test will be performed.
Shipping Instructions
Advise Express Mail or equivalent if not on courier service.
Necessary Information
1. 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, but appropriate testing and interpretation may be compromised or delayed. If this information is not provided, an appropriate indication for testing may be entered by Mayo Clinic Laboratories.
2. If the patient has received an opposite sex bone marrow transplant, note this information on the request.
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.
Acceptable
Specimen Type: Blood
Container/Tube:
Preferred: Yellow top (ACD)
Acceptable: Green top (heparin) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions: Invert several times to mix blood.
Useful For
Detecting a neoplastic clone associated with the common chromosome abnormalities and classic rearrangements seen in pediatric/young 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 9 probe sets (18 individual fluorescence in situ hybridization [FISH] probes). Additional charges will be incurred for all reflex or additional probe sets performed.
The diagnostic pediatric/young adult T-ALL FISH panel includes testing for the following abnormalities using the FISH probes listed:
+9/9p-, CDKN2A/D9Z1
t(9;22) or ABL1 amplification, ABL1/BCR
11q23 rearrangement, MLL (KMT2A) break-apart
-17/17p-, TP53/D17Z1
t(5;14), TLX3/BCL11B
7q34 rearrangement, TRB break-apart
14q11.2 rearrangement, TRAD break-apart
t(10;11), MLLT10/PICALM
1p33 rearrangement, TAL1/STIL
When an MLL (KMT2A) rearrangement is identified, reflex testing will be performed to identify the translocation partner. Probes include identification of:
t(11;19)(q23;p13.3) MLL/MLLT1
t(6;11)(q27;q23) MLLT4(AFDN)/MLL
t(4;11)(q21;q23) AFF1/MLL
t(9;11)(p22;q23) MLLT3/MLL
t(10;11)(p12;q23) MLLT10/MLL
t(11;19)(q23;p13.1) MLL/ELL.
When a TRAD rearrangement is identified, reflex testing will be performed to identify the translocation partner. Probes include identification of:
t(11;14)(p15;q11.2) LMO1/TRAD
t(8;14)(q24.1;q11.2) MYC/TRAD
t(10;14)(q24;q11.2) TLX1(HOX11)/TRAD
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
t(7;11)(q34;p15) TRB/LMO1
t(7;11)(q34;p13) TRB/LMO2
t(6;7)(q23;q34) MYB/TRB.
In the absence of BCR/ABL1 fusion or apparent episomal amplification of ABL1, when an extra ABL1 signal is identified, reflex testing will be performed using the ABL1 break-apart probe set to evaluate for the presence or absence of an ABL1 rearrangement.
For more information See Acute Leukemias of Ambiguous Lineage Testing Algorithm
Method Name
Fluorescence In Situ Hybridization (FISH)
Reporting Name
Pediatric 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
88271x18, 88275x9, 88291x1- FISH Probe, Analysis, Interpretation; 9 probe sets
88271x2, 88275x1-FISH Probe, Analysis; each additional probe set (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
TALPF | Pediatric ALL (T-cell), FISH | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
609568 | Result Summary | 50397-9 |
609569 | Interpretation | 69965-2 |
609570 | Result Table | 93356-4 |
609571 | Result | 62356-1 |
GC074 | Reason for Referral | 42349-1 |
GC075 | Specimen | 31208-2 |
609572 | Source | 31208-2 |
609573 | Method | 85069-3 |
609574 | Additional Information | 48767-8 |
609575 | Disclaimer | 62364-5 |
609576 | Released By | 18771-6 |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
TALPB | Probe, Each Additional (TALPF) | No, (Bill Only) | No |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.