Sorted By Test Name - Mayo Medical Laboratories

FCLL
83089
Negative
Interpretation depends on clinical setting. See Viral Hepatitis Serologic Profiles in Special Instructions.
Clinical References: 1. Wietzke P, Schott P, Braun F, et al: Clearance of HCV RNA in a chronic
hepatitis C virus-infected patient during acute hepatitis B virus superinfection. Liver 1999;19:348-353 2.
Villari D, Pernice M, Spinella S, et al: Chronic hepatitis in patients with active hepatitis B virus and
hepatitis C virus combined infections: a histological study. Am J Gastroenterol 1995;90:955-958 3.
Schmilovitz-Weiss H, Levy M, Thompson N, Dusheiko G: Viral markers in the treatment of hepatitis B
and C. Gut 1993;34 (2 Suppl):S26-S35
Chronic Lymphocytic Leukemia (CLL), FISH
Clinical Information: B-cell chronic lymphocytic leukemia (B-CLL) is the most common leukemia
in North America. Certain cytogenetic abnormalities, gene mutations, and protein products contribute to
disease progression and survival in B-CLL, but the primary oncogenic event is unknown. The most
common cytogenetic anomalies in B-CLL involve chromosomes 6, 11, 12, 13, and 17. Use of
CpG-oligonucleotide mitogen (CPG/89090 Chromosome Analysis, CpG Mitogen Study for B-Cell
Disorder) will identify an abnormal CLL karyotype in at least 80% of cases. Unstimulated conventional
chromosome studies (BM/8506 Chromosome Analysis, Hematologic Disorders, Bone Marrow and
HBL/8537 Chromosome Analysis, Hematologic Disorders, Blood) are usually not successful for B-cell
CLL. Molecular genetic analyses of patients with B-CLL are problematic, as these studies are hampered
by the presence of nonclonal cells and by limited knowledge of candidate genes. Methods using
chromosome-specific fluorescent-labeled DNA probes and FISH permit detection of various trisomies,
deletions, and translocations in nondividing cells of patients with B-CLL. Disease can be quantified
before and after therapy. This test detects abnormal clones in approximately 60% of patients with indolent
disease and >80% of patients that require treatment (see Supportive Data). At least 7% of patients referred
for CLL FISH testing have translocations involving the IgH locus; approximately 77% of these patients
have translocations that result in fusion of IGH/CCND1, IGH/BCL2, or IGH/BCL3. The CCND1, BCL2,
and BCL3 genes are located on chromosome 11, 18, and 19, respectively. Fusion of IGH and CCND1 is
associated with t(11;14)(q13;q32), IGH and BCL2 with t(14;18)(q32;q21), and IGH and BCL3 with
t(14;19)(q32;q13.3). Patients with t(11;14)(q13;q32) usually have the leukemic phase of mantle cell
lymphoma, while patients with t(14;18)(q32;q21) or t(14;19)(q32;q13.3) have an atypical form of B-CLL
or the leukemic phase of a lymphoma. Chromosome anomalies detected by this FISH assay reportedly are
associated with prognosis, in a hierarchy, from best to worst prognosis, as follows:13q-, normal, +12, 6q-,
11q-, and 17p-.
Useful For: Detecting clones with abnormalities of chromosomes 6, 11, 12, 13, 14, 17, 18, or 19 in
patients with B-cell chronic lymphocytic leukemia (B-CLL) Quantifying disease before and after therapy
in patients with B-CLL Distinguishing patients with 11;14 translocations who have leukemic phase of
mantle cell lymphoma from patients who have B-CLL Detecting patients with atypical B-CLL or other
forms of lymphoma associated with 14;18 or 14;19 translocations
Interpretation: A neoplastic clone is detected when the percent of cells with any given chromosome
abnormality exceeds the normal reference range. Normal cutoff (based on upper boundary for a 95%
confidence interval): Abnormality Reference Range Deletion in 6q, 11q, 13q, or 17p