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Test Code HOLDC Hematologic Disorders, Chromosome Hold, Varies

Reporting Name

Heme Chromosome Hold, B/BM

Useful For

Holding the bone marrow or peripheral blood specimen in the laboratory but delaying chromosome analysis while preliminary morphologic assessment is in process

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
CHRBM Chromosomes, Hematologic, BM Yes No
CHRHB Chromosomes, Hematologic, Blood Yes No

Testing Algorithm

This test is designed to hold the specimen but delay chromosome preparation and analysis while preliminary morphologic assessment is in process.

 

Upon specimen receipt, the specimen will be held in the laboratory. Chromosome analysis will be performed unless the test is canceled (see Hold policy).

 

If the client notifies the laboratory that chromosome analysis is not necessary, this test will be reported as "Canceled." Chromosome analysis will not be performed but a processing fee will be charged.

 

If the client does not notify the laboratory that chromosome analysis is not needed (see Hold policy), this test will be reported as "Reflexed," and chromosome analysis will be performed. Depending on the specimen received, the appropriate reflex test will be performed. No processing fee will be assessed for this test as culture charges are included in the reflexed test.

 

Hold policy: The client must contact the Cytogenetics Laboratory at 800-533-1710 by 3 p.m. (Central time) no later than 2 business days after the specimen was collected to notify the lab not to proceed with chromosome analysis. If no notification is received by this time, chromosome analysis will be performed and charged. Weekend communication can be deferred until Monday.

Method Name

Direct Preparation of Specimen

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Ordering Guidance


This test does not apply to any fluorescence in situ hybridization (FISH) assays. If specimen is to be held for FISH testing, order HOLDF / Hematologic Disorders, Fluorescence In Situ Hybridization (FISH) Hold, Varies.

 

Chromosome analysis is not recommended for plasma cell neoplasms due to limited clinical utility.(1)

-If this test and a plasma cell FISH test (PCPDS / Plasma Cell Proliferative Disorder, High-Risk with Reflex Probes, Diagnostic FISH Evaluation, Bone Marrow MSMRT / Mayo Algorithmic Approach for Stratification of Myeloma and Risk-Adapted Therapy Report, Bone Marrow; or MFCDF / Myeloma Fixed Cell, High Risk with Reflex Probes, Diagnostic FISH Evaluation, Varies) are ordered concurrently, this test will be canceled and no processing fee will be charged.

-If a secondary myeloid neoplasm is suspected and both this test and a plasma cell FISH (PCPDS/MSMRT/MFCDF) are needed, contact the Cytogenetics Communication Team at 800-533-1710 before sending the specimen.



Shipping Instructions


Advise Express Mail or equivalent if not sent via courier service.



Necessary Information


Provide a reason for testing and bone marrow pathology report (if available) with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.



Specimen Required


Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Bone marrow

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (sodium heparin), lavender top (EDTA)

Specimen Volume: 1 to 2 mL

Collection Instructions: Invert several times to mix bone marrow.

 

Acceptable:

Specimen Type: Blood

Container/Tube:

Preferred: Yellow top (ACD)

Acceptable: Green top (sodium heparin), lavender top (EDTA)

Specimen Volume: 6 mL

Collection Instructions: Invert several times to mix blood.


Specimen Minimum Volume

Blood: 2 mL
Bone marrow: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
  Refrigerated 

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

Not applicable

Day(s) Performed

Monday through Sunday

CPT Code Information

See Individual Components

LOINC Code Information

Result ID Test Result Name Result LOINC Value
52290 Result Summary 50397-9
52292 Interpretation 69965-2
CG763 Reason for Referral 42349-1
CG764 Specimen 31208-2
52293 Source 31208-2
55267 Requested FISH Test 48767-8
52295 Method 85069-3
54639 Additional Information 48767-8
52296 Released by 18771-6

Clinical Information

Conventional chromosome analysis is the gold standard for identification of the common, recurrent chromosome abnormalities for most hematologic malignancies. Based on morphologic review of the bone marrow or peripheral blood specimen by a hematopathologist, a determination of additional appropriate testing can be made. If the specimen does not show evidence of malignancy, chromosome analysis may not be necessary. Depending on the diagnosis, fluorescence in situ hybridization assays may also be more informative.

Interpretation

If notified by the client, this test may be canceled, and a processing fee assessed.

 

If no notification to cancel testing is received, this test will be reported as "reflexed for chromosome analysis" and depending on the specimen received, CHRBM / Chromosome Analysis, Hematologic Disorders, Bone Marrow or CHRHB / Chromosome Analysis, Hematologic Disorders, Blood will be performed, and an interpretive report provided.

Cautions

No significant cautionary statements

Method Description

The specimen will be held in the laboratory while preliminary morphologic assessment is in process to determine if chromosome analysis is appropriate. If needed, cell culture and chromosome analysis will be performed.

Report Available

7 to 10 days

Specimen Retention Time

4 weeks

Secondary ID

35848

Forms

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

Test Classification

Not Applicable

Clinical Reference

1. Mellors PW, Binder M, Ketterling RH, et al. Metaphase cytogenetics and plasma cell proliferation index for risk stratification in newly diagnosed multiple myeloma. Blood Adv. 2020;4(10):2236-2244