Hematologic Disorders, Leukemia/Lymphoma; Flow Hold, Varies

Casandra

Casandra Test Code MC36002Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID HLLFHCPT Codes 88184, 88185, 88187, 88188, 88189

Hematologic Disorders, Leukemia/Lymphoma; Flow Hold, Varies

Clinical Use

Use

The test is critical for evaluating lymphocytoses of undetermined etiology and identifying B- and T-cell lymphoproliferative disorders involving blood and bone marrow. It aids in distinguishing acute lymphoblastic leukemia from acute myeloid leukemia (AML) and allows for the immunologic subtyping of acute leukemias. Additionally, the test is used for distinguishing reactive lymphocytes, lymphoid hyperplasia from malignant lymphoma, and between malignant lymphoma and acute leukemia. It is also useful for the 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 is another application, as well as recognizing monoclonal plasma cells. Notably, the test is not intended for the detection of minimal residual disease below 5% blasts.

Special Instructions

The test is not appropriate for diagnosing sarcoidosis, hypersensitivity pneumonitis, interstitial lung diseases, or differentiating between pulmonary tuberculosis and sarcoidosis. Specimens sent for these purposes will be rejected. It is also not intended for products of conception (POC) specimens.

Limitations

Viability is assessed in all tissue specimens. Cases with less than 50% viability must be interpreted with caution and may yield false-negative results. Fine-needle aspiration and small biopsy specimens often have low cell counts and poor viability, which may be uninterpretable. The test's ability to detect minimal residual disease is limited to above 5% blasts.

Test Details

New York Approved