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HelpOncology FISH
Clinical System Name
Oncology FISH
Synonyms
Leukemia FISH
Neoplasia FISH
Leukemic Peripheral Blood FISH
FISH - Bone Marrow/Leukemic Peripheral Blood
Description
Bone marrow/leukemic peripheral blood cells are processed and cultured for chromosome analysis and fluorescence in-situ hybridization (FISH) in the diagnosis of leukemia and other hematologic disorders. A leukemic peripheral blood sample with >5% circulating blasts can be used when a bone marrow sample can not be obtained.
Sample Requirements
Specimen: Bone Marrow (BM) or Leukemic peripheral blood (LPB)
Container(s): Dark Green/Sodium Heparin (no serum separator)
Preferred Vol: BM: 3 mL
LPB: 5 mL
Minimum Vol: BM: 1 mL; no micro collection
LPB: 3 mL; no micro collection
Note: For more detailed information for bone marrow testing, see separate bone marrow aspirate listing.
A bone marrow sample is the preferred sample type for testing. Collect 1 - 3 mL bone marrow and transfer marrow from syringe to plain green top sodium heparin tube (DARK GREEN) with no gel separator - see above.
A leukemic peripheral blood sample with >5% circulating blasts can be used when a bone marrow sample can not be obtained. Collect 3 - 5 mL leukemic peripheral blood into a plain green top sodium heparin tube without gel separator.
Keep sample at room temperature and send to the Lab immediately. Samples received after 3 pm will be set up the following day.
Processing Instructions
Reject due to: n/a - send to lab
Spin: N
Aliquot: N
Temp: RT
Storage location: Days: Transport specimen, requistion, and labels with other bone marrow samples to 4th floor Cell Markers (station #181). Eves/Nights: Store specimen with other bone marrow samples, copy of requisition, and labels in the Cell Markers RT box in CPA.
Off-site collection - Bone Marrow: See Bone Marrow Aspirate listing for complete instructions. 'Seattle Children's Bone Marrow (off-site) - Flow, Morphology, Cytogenetics' requisition must be completed by ordering provider. Specimen must reach Children's Laboratory within 24 hours of collection. Samples received after 3 pm will be set up the following day.
Stability
| Temperature | Time |
|---|---|
| Room temp | 24 hours |
| Refrigerated | No |
| Frozen | No |
Availability
| STAT | Performed | TAT |
|---|---|---|
| N | Daily | Abnormal prelim within 1 week if requested; final in 2-3 weeks |
Performing Laboratory
Seattle Children's Hospital
Department
Department: Cytogenetics Laboratory
Phone number: 206-987-3961
Lab Client Services: 206-987-2617, labclientservices@seattlechildrens.org
Lab Genetic Counselor: LabGC@seattlechildrens.org
CPT Codes
Contact Lab Client Services, 206-987-2617 or labclientservices@seattlechildrens.org
Methodology
Method: Fluorescent in-situ hybridization
Requisition
Complete & include copy of Clinical Information System (CIS) HemOnc Bone Marrow Requisition (cases to be evaluated by Seattle Children's Pathology) or Hematopoietic Transplant Marrow Requisition (specimens to be evaluated at Seattle Cancer Care Alliance), as appropriate.
For specimens collected off-site: complete & include Seattle Childrens Bone Marrow/Malignancy (Off-site collection) - Flow, Morphology, Cytogenetics requisition. (see 'Bone Marrow Aspirate' listing)
Special Instructions
Test request form should be completed by the ordering physician. For additional information or consultation call the Cytogenetics Lab at (206) 987-3961. Evening and night shift: call the Clinical Lab at (206) 987-2102 or the on-call pathologist at (206) 987-2131.
Clinical Utility
Chromosomes contain the thousands of genes in the human genome that direct cellular processes controlling growth, development, and functioning of the human body. Acquired chromosomal abnormalities including chromosomal gains, losses, and structural abnormalities have all been associated with cancer. Identification of specific abnormalities by FISH and Karyotype can help with diagnosis of disease, risk stratification, and prognosis. Abnormalities detected by FISH and karyotype may be used to monitor disease in follow up studies.
Karyotype testing will detect abnormalities in chromosome number, large chromosomal duplications and deletions and other large structural rearrangements.
FISH testing is used for more targeted studies to confirm or rule out specific abnormalities.