Sorted By Test Name - Mayo Medical Laboratories

IMPR
8126
CMPD. These translocations can also be seen in lymphoid neoplasms, including acute lymphoblastic
leukemia (ALL) and lymphomas, and they can also possess a varied genetic etiology. Several clinical
studies have demonstrated that the malignancies displaying overexpression of these genes are responsive
to imatinib mesylate (Gleevec), a drug that specifically targets these genes.
Useful For: Detecting a neoplastic clone associated with the common chromosome anomalies seen in
patients with acute leukemia or other myeloid malignancies Tracking known chromosome abnormalities
in patients with myeloid malignancies thus assessing their response to therapy. This panel is particularly
useful for specimens in which standard cytogenetic analysis is unsuccessful.
Interpretation: A neoplastic clone is detected when the percent of cells with an abnormality exceeds
the normal cutoff for any given probe. The presence of a positive clone supports a diagnosis of
malignancy. The absence of an abnormal clone does not rule out the presence of neoplastic disorder.
Reference Values:
An interpretive report will be provided.
Clinical References: 1. Trempat P, Villalva C, Laurent G, et al: Chronic myeloproliferative
disorders with rearrangement of the platelet-derived growth factor alpha receptor; a new clinical target for
STI571/Glivec. Oncogene 2003 Aug 28;22(36):5702-5706 2. Dave BJ, Wiggins M, Higgeins CM, et al:
9q34 rearrangements in BCR/ABL fusion-negative acute lymphoblastic leukemia. Cancer Genet
Cytogenet 2005 Oct 1;162:30-37 3. Pardanani A, Reeder T, Porrata LF, et al: Imatinib therapy for
hypereosinophilic syndrome and other eosinophilic disorders. Blood 2003 May 1;101(9):3391-3397 4.
Pardanani A, Tefferi A: Imatinib targets other than bcr/abl and their clinical relevance in myeloid
disorders. Blood 2004 Oct 1;104(7):1931-1939
Imipramine and Desipramine, Serum
Clinical Information: Imipramine and its metabolite desipramine are tricyclic antidepressants used to
treat endogenous depression requiring 1 to 3 weeks of treatment before therapeutic effectiveness becomes
apparent. Desipramine is used for treatment of endogenous depression when the patient needs a drug with
significant stimulatory side effects. These drugs have also been employed in the treatment of enuresis
(involuntary urination) in childhood and severe obsessive-compulsive neurosis. Imipramine The optimal
dosage of imipramine yields trough (just before the next dose) blood levels of imipramine and
desipramine combined from 175 to 300 ng/mL. If desipramine is given, no imipramine should be detected
and the therapeutic concentration for desipramine alone is 100 to 300 ng/mL. Toxicity associated with
imipramine is characterized by QRS widening leading to ventricular tachycardia and asystole. In some
patients, toxicity may manifest at lower concentrations, or at therapeutic concentrations in the early state
of therapy. Cardiac toxicity (first-degree heart block) is usually associated with blood concentrations in
excess of 300 ng/mL. Desipramine Desipramine is the antidepressant of choice in patients where maximal
stimulation is indicated. The therapeutic concentration of desipramine is 100 to 300 ng/mL. About 1 to 3
weeks of treatment are required before therapeutic effectiveness becomes apparent. The most frequent
side effects are those attributable to anticholinergic effects; dry mouth, constipation, dizziness,
tachycardia, palpitations, blurred vision, and urinary retention. These occur at blood concentrations in
excess of 300 ng/mL, although they may occur at therapeutic concentrations in the early stage of therapy.
Cardiac toxicity (first-degree heart block) is usually associated with blood concentrations in excess of 300
ng/mL.
Useful For: Monitoring serum concentration during therapy Evaluating potential toxicity The test may
also be useful to evaluate patient compliance
Interpretation: Most individuals display optimal response to imipramine when combined serum levels
of imipramine and desipramine are between 175 and 300 ng/mL. Risk of toxicity is increased with levels
> or =300 ng/mL. Most individuals display optimal response to desipramine with serum levels of 100 to
300 ng/mL. Risk of toxicity is increased with desipramine levels > or =300 ng/mL. Some individuals may
respond well outside of these ranges, or may display toxicity within the therapeutic range, thus
interpretation should include clinical evaluation. Therapeutic ranges are based on specimen drawn at
trough (ie, immediately before the next dose).
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