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HelpTest Code MYEFL Myelodysplastic Syndrome by Flow Cytometry, Bone Marrow
Reporting Name
MDS by Flow Cytometry, BMPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Detecting increased blasts
Characterizing blast phenotypes
Identifying abnormal patterns of myeloid maturation as seen in myelodysplastic syndromes and other clonal myeloid neoplasms
Providing additional adjunct diagnostic information in cases with equivocal or suspicious morphologic features for myelodysplastic syndrome (MDS), MDS/myeloproliferative neoplasms including chronic myelomonocytic leukemia, and other clonal myeloid neoplasms
Method Name
Immunophenotyping
Additional Testing Requirements
If cytogenetic tests are also desired when collecting MYEFL / Myelodysplastic Syndrome by Flow Cytometry, Bone Marrow, an additional specimen should be submitted. It is important that the specimen be obtained, processed, and transported according to instructions for the other required test.
Shipping Instructions
Specimen must be received within 3 days of collection.
Specimen Required
Container/Tube:
Preferred: Yellow top (ACD solution A or B
Acceptable: Lavender top (EDTA), green top (heparin)
Specimen Volume: 2-5 mL
Slides: Include 5 to 10 unstained bone marrow aspirate smears, if possible, labeled with 2 unique identifiers.
Collection Instructions:
1. Submission of bilateral specimens is not required.
2. Label specimen as bone marrow.
Specimen Type
Bone MarrowSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Bone Marrow | Ambient | ||
Reject Due To
| Gross hemolysis | Reject |
Reference Values
An interpretive report will be provided. This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and, if available, morphologic features will be provided by a board-certified hematopathologist for every case.
Interpretation
The final interpretation integrates 1) the quantity of blasts; 2) blast phenotype with respect to CD13/HLA-DR expression and/or abnormal coexpression of CD2, CD7, and/or CD56; and 3) myeloid maturation patterns based on CD13/CD16 plot. In combination, the total number of abnormalities detected and the distinctiveness of the abnormalities themselves help determine the likelihood of specimen involvement by a clonal myeloid neoplasm.
Day(s) Performed
Monday through Saturday
Report Available
1 to 4 daysTest Classification
This test was developed using an analyte specific reagent. Its performance characteristics were 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
88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1
88185-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each) x18
88189-Flow Cytometry Interpretation, 16 or More Markers (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MYEFL | MDS by Flow Cytometry, BM | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CK086 | MDS Panel | No LOINC Needed |
| CK092 | Final Diagnosis | 22637-3 |
| CK093 | Special Studies | 30954-2 |
| CK094 | Microscopic Description | 22635-7 |
Forms
If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FCINS | Flow Cytometry Interp,16 or greater | No, (Bill Only) | No |
Testing Algorithm
This assay uses 2 panels for identifying cell populations of interest and for characterizing their phenotypic features. In the myelodysplastic syndrome panel, blasts are identified by CD45/side scatter gating strategy and by CD34 expression; promyelocytes are identified by bright CD13, CD33, and CD117 expression without CD34; granulocytes and precursors are defined by their variable expression of CD13 and CD16 according to their maturational stages. Abnormal patterns of myeloid maturation are determined according to the presence or absence of the following features: distinct blast increases over 5%; heterogeneous blast distribution on CD13/HLA-DR plot; expression of CD2, CD7, and/or CD56 on blasts; and disrupted granulocytic maturation on CD13/CD16 plot.(1,2)
Additionally, a triage panel is performed to ensure that monotypic B-cells, increased plasma cells, and phenotypically aberrant populations of CD3-positive T-cells and CD16-positive/CD3-negative natural killer (NK) cells, if present, are identified. This is necessary especially for cases where the reason for referral is broad, where clonal myeloid neoplasms may not be the only diagnostic consideration, or where there is incomplete clinical history and morphologic data.
These panels are used in combination with any available provided clinical history and morphologic findings to determine if any additional testing may be needed for complete disease characterization. If such additional testing is required, it will be added according to laboratory algorithms at an additional charge per unique antibody tested.
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ADD1 | Flow Cytometry, Cell Surface, Addl | No, (Bill Only) | Yes |
| FIRST | Flow Cytometry, Cell Surface, First | No, (Bill only) | Yes |