B-cell and T-cell acute lymphoblastic leukemia
Individualized test options
In the United States, the incidence of acute lymphoblastic leukemia (ALL) is approximately 1 in 50,000. Acute lymphoblastic leukemia accounts for approximately 70% of all childhood leukemia cases (ages 0 to 19 years), making it the most common type of childhood cancer. It has a peak incidence at 2–5 years of age. The incidence decreases with increasing age, before increasing again at around age 50.
Our fluorescence in situ hybridization (FISH) testing is designed to simplify the ordering process by providing diagnostic panels that include all appropriate genes.
B-cell and T-cell acute lymphoblastic leukemia Test menu
B-cell and T-cell acute lymphoblastic leukemia
A combination of cytogenetic and FISH testing is currently recommended in all pediatric and adult patients to characterize the B-ALL and T-ALL clones for the prognostic genetic subgroups. Each of the genetic subgroups is important to detect, can be critical prognostic markers, and can assist in treatment selection.
A newly recognized World Health Organization (WHO) entity BCR-ABL1-like ALL, also known as Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL), is increasing in importance due to the poor prognosis seen in pediatric, adolescent, and young adult ALL. Common features of this entity involve rearrangements with tyrosine kinase genes involving the following: ABL2, PDGFRB, JAK2, ABL1, CRLF2, P2RY8, and deletions involving IKZF1. Patients who have failed conventional therapies have demonstrated favorable responses to targeted therapies when rearrangements involving these specific gene regions have been identified.
Key testing
- BALAF | B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies
- Performed on specimens from patients ages 31 and older with B-ALL/lymphoma.
- BALPF | B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Pediatric, FISH, Varies
- Performed on specimens from patients ages 30 and younger with B-ALL/lymphoma.
- BALMF | B-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Specified FISH, Varies
- Probe set(s) to be performed must be specified upon ordering. Any probe set(s) captured under BALAF, BALPF, or PHLDF can be ordered.
- BLBLF | B-Cell Lymphoblastic Leukemia/Lymphoma, FISH, Tissue
- Performed on paraffin-embedded tissue. When ordered, entire BLBL FISH panel will be performed. Panel performed will be determined by age.
- PHLDF | Philadelphia Chromosome-like Acute Lymphoblastic Leukemia (Ph-like ALL), Diagnostic FISH, Varies
- When ordered, the entire Ph-like B-ALL FISH panel will be performed. If individual probes from this panel are desired, order under BALMF.
- TALAF | T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Adult, Varies
- Performed on specimens from patients ages 31 and older with T-ALL/lymphoma.
- TALPF | T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), FISH, Pediatric, Varies
- Performed on specimens from patients ages 30 and younger with T-ALL/lymphoma.
- TALMF | T-Cell Acute Lymphoblastic Leukemia/Lymphoma (ALL), Specified FISH, Varies
- Probe set(s) to be performed must be specified upon ordering. Any probe set captured under TALAF or TALPF can be ordered.
- CILPF | Congenital Infantile Leukemia, FISH, Tissue
- Detecting a neoplastic clone associated with the common chromosome abnormalities and classic rearrangements seen in infant patients with leukemia using tissue specimens.
- CHRBM | Chromosome Analysis, Hematologic Disorders, Bone Marrow
- Assisting in the diagnosis and classification of certain malignant hematological disorders.
Highlights
Min Shi, M.D., Ph.D., a hematologist and co-director of Mayo Clinic's Flow Cytometry Laboratory, explains recent updates to the B-cell lymphoblastic leukemia minimal residual disease flow cytometry assay. This test is used to identify minimal residual disease in patients with a previously confirmed diagnosis of B-cell lymphoblastic leukemia who have completed chemotherapy, immunotherapy or bone marrow transplantation.