Immunoglobulin Gene Rearrangement, Blood

Casandra

Casandra Test Code MC67225Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID BCGRCPT Codes 81261, 81264

Immunoglobulin Gene Rearrangement, Blood

Clinical Use

Use

The Immunoglobulin Gene Rearrangement test is useful for determining whether a B-cell or plasma cell population is polyclonal or monoclonal using whole blood specimens. It helps in identifying neoplastic cells as having B-cell or plasma cell differentiation. Additionally, the test is used to monitor for a persistent neoplasm by detecting an immunoglobulin gene rearrangement profile similar to one from a previous neoplastic specimen. The test also aids in understanding the presence of a prominent immunoglobulin gene rearrangement profile in the context of neoplastic B-cell or plasma cell clones.

Special Instructions

Specimen must arrive within 7 days of collection. Ensure to invert several times to mix blood. Send whole blood specimen in the original tube, and do not aliquot. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request form with the specimen.

Limitations

This test is not 100% sensitive or specific. False-negative results may occur if the immunoglobulin gene has numerous point alterations introduced during somatic hypermutation, preventing PCR primer binding. The assay may not detect clonal cells that have not rearranged the Ig genes evaluated or are below the sensitivity level of the assay (requires at least 1%-5% clonal presence). False-positive results, though rare, may appear if a prominent clone is sampled from polyclonal expansion. The test cannot determine the differentiation of clonal cells or if a prominent clone is physiological or neoplastic.

Test Details

New York Approved