|Values are valid only on day of printing.|
Evaluating lymphocytoses of undetermined etiology
Identifying B- and T-cell lymphoproliferative disorders involving blood and bone marrow
Distinguishing acute lymphoblastic leukemia from acute myeloid leukemia (AML)
Immunologic subtyping of acute leukemias
Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma
Distinguishing between malignant lymphoma and acute leukemia
Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia
Recognizing AML with minimal morphologic or cytochemical evidence of differentiation
Recognizing monoclonal plasma cells
|Test ID||Reporting Name||Available Separately||Always Performed|
|FIRST||Flow Cytometry, Cell Surface, First||No, (Bill Only)||No|
|ADD1||Flow Cytometry, Cell Surface, Addl||No, (Bill Only)||No|
|FCINT||Flow Cytometry Interp, 2-8 Markers||No, (Bill Only)||No|
|FCIMS||Flow Cytometry Interp, 9-15 Markers||No, (Bill Only)||No|
|FCINS||Flow Cytometry Interp,16 or greater||No, (Bill Only)||No|
Note: This test is only available to clients who have MayoAccess or MayoLink
The client is responsible for the interpretation and billing of the professional component; Mayo Clinic will bill the technical component only.
A triage panel is always performed. The panel is charged based on number of markers tested (FIRST for first marker, ADD1 for each additional marker). In addition, reflex testing may occur to fully characterize a disease state or clarify any abnormalities from the screening test. Reflex tests will be performed at an additional charge for each marker tested (ADD1 if applicable).
For blood bone marrow, and fluid specimens, the triage panel evaluates monotypic B-cells by kappa and lambda light chain expression, increased numbers of blasts by CD34 and CD45 expression along with side scatter gating, and increased plasma cells by CD45 expression and side scatter gating. The panel also includes antibodies to assess the number of CD3-positive T cells and CD16-positive/CD3-negative natural killer (NK) cells present. This panel also determines if there is an increase in the number of T cells that aberrantly coexpress CD16, an immunophenotypic feature of T-cell granular lymphocytic leukemia.
For tissue specimens, the triage panel includes evaluation for monotypic B cells by kappa and lambda light chain expression, CD5, CD10, CD19, CD20, and CD23. Increased numbers of blasts and plasma cells are identified by CD45 expression along with side scatter gating. The panel can also evaluate T cells with CD3, CD5, and CD7. Additionally, viability is assessed on all tissue specimens using 7-AAD exclusion.
This panel, together with the provided clinical history and morphologic review will determine if additional testing is required. If additional testing is needed, it will be added per algorithm to fully characterize a disease state with a charge per unique antibody tested.
Cases requiring the granular lymphocytic leukemia flow panel or V-beta panel will have an interpretation added and performed by a Mayo Clinic pathologist.
If no abnormalities are detected by the triage panel, no further flow cytometric assessment will be performed unless otherwise indicated by specific features of the clinical presentation or prior laboratory results.
Bone marrow specimens being evaluated for possible involvement by a myelodysplastic syndrome (MDS) or a myelodysplastic/myeloproliferative neoplasm (MDS/MPN) including chronic myelomonocytic leukemia (CMML) should be ordered as MYEFL / Myelodysplastic Syndrome by Flow Cytometry, Bone Marrow, not this test.
The following algorithms are available in Special Instructions:
-Malignant Lymphoma, Guideline for Bone Marrow Staging Studies
-Acute Promyelocytic Leukemia: Guideline to Diagnosis and Follow-up