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Test Code PML/RARA Qnt PML::RARA Quantitative, PCR, Varies

Reporting Name

PML/RARA Quantitative, PCR

Useful For

Diagnosis of acute promyelocytic leukemia (APL)

 

Detection of residual or recurrent APL

 

Monitoring the level of PML::RARA (promyelocytic leukemia/retinoic acid receptor alpha) in APL patients


Ordering Guidance


This assay may not detect rare, unusual PML::RARA fusions. Therefore, if the assay is going to be used for monitoring after treatment, the test should be performed at the time of diagnosis to ensure that the test gives a positive result.



Shipping Instructions


1. Refrigerated specimens must arrive within 5 days of collection, and ambient specimens must arrive within 3 days of collection.

2. Collect and package specimen as close to shipping time as possible.



Necessary Information


The following information is required:

1. Pertinent clinical history

2. Date of collection

3. Specimen source (blood or bone marrow)



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Whole blood

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 10 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Send whole blood specimen in original tube. Do not aliquot.

3. Label specimen as blood.

 

Specimen Type: Bone marrow

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 4 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Send bone marrow specimen in original tube. Do not aliquot

3. Label specimen as bone marrow.


Seattle Children's Hospital Note:

MUST ARRIVE @ MAYO WITHIN 72 HOURS. Samples collected on a Friday must be received in the SCH main lab before 7 pm. Samples can be collected on the weekend as long as the following Monday is not a holiday.

Specimen Type

Varies

Specimen Minimum Volume

Blood: 8 mL; Bone Marrow: 2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 5 days PURPLE OR PINK TOP/EDTA
  Ambient  72 hours PURPLE OR PINK TOP/EDTA

Day(s) Performed

Monday through Saturday

Seattle Children's Hospital Note:

TAT: 6 - 10 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Method Name

Quantitative, Real-Time Polymerase Chain Reaction (PCR)

Method Description

Total RNA is extracted from blood or bone marrow and reverse transcribed to generate complementary DNA. Quantitative real-time polymerase chain reaction is performed using the LightCycler instrument platform (Roche) and the data analyzed using the dedicated software for relative quantification with calibrator normalization. Results are provided as a normalized relative value of PML::RARA/ABL1 messenger RNA (mRNA) with a reproducible analytical sensitivity of 0.003%(Unpublished Mayo method).

 

The normalized ratio is a relative quantification calculation as follows: 

Normalized ratio*=

PML::RARA (sample)

ABL1 (sample)

PML::RARA (calibrator)

ABL1 (calibrator)

 

*Where ABL1 mRNA is used to normalize variations in RNA quality and calibrator mRNA from a PML::RARA-positive cell line is used to normalize variations in run conditions.

Reference Values

An interpretive report will be provided.

 

If positive, a value representing a ratio of PML::RARA fusion transcript to the control gene ABL1 expressed as a percentage will be reported.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

81315-PML/RAR-alpha (t(15;17)), (PML-RARA regulated adaptor molecule 1) (eg, promyelocytic leukemia) translocation analysis; all breakpoints (eg, intron 3, intron 6 and variable in exon 6), qualitative or quantitative

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PMLR PML/RARA Quantitative, PCR In Process

 

Result ID Test Result Name Result LOINC Value
39469 PMLR Result No LOINC Needed
MP012 Specimen Type 31208-2
19449 Interpretation 69047-9

Testing Algorithm

For more information see Acute Promyelocytic Leukemia: Guideline to Diagnosis and Follow-up

Report Available

4 to 8 days

Reject Due To

Gross hemolysis Reject
Moderately to severely clotted Reject

Forms

1. Hematopathology Patient Information (T676)

2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.