All Tests

Hematology Profile Plus-NGS

Hematology Profile Plus combines expression and fusion with mutation analysis in DNA and RNA. The test covers 284 DNA genes and more than 1600 RNA genes. This is a comprehensive evaluation for all hematologic neoplasms. However, it is especially recommended for:

Acute Myeloid Leukemia (AML): Translocations in AML are very important for diagnosis, prognosis and therapy selection. This comprehensive test can provide a complete evaluation of fusion mRNA and mutations. It also helps in determining a diagnosis in acute leukemia with ambiguous phenotype.

Clonal Hematopoiesis of Indeterminate Potential (CHIP): Distinguish CHIP from clinically active and relevant hematologic neoplasm based on an internally developed algorithm using variant allele frequency, chromosomal structural abnormalities, clinical and laboratory data and longitudinal data. This distinction is particularly important when evaluating minimal residual disease and in the presence of other neoplastic processes.

VEXAS Syndrome: Recently described VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is caused by mutations in the UBA1 gene. This is an adults-onset fatal disease that may present as myelodysplastic syndrome, aplastic anemia or multiple myeloma, but is also characterized by fevers, low white cell count, vacuoles in bone marrow cells, dysplastic bone marrow, pulmonary inflammation, chondritis, and vasculitis. Detecting the presence of mutations in the UBA1 gene is the only way to confirm the diagnosis of this syndrome.

Acute Lymphoblastic Leukemia (ALL): This comprehensive assay is designed to confirm the diagnosis of Ph+ (BCR::ABL1-positive) ALL and Ph-like (BCR::ABL1-like) ALL and distinguish them from other types of ALL. It can be used for diagnosis as well as for monitoring. The incidence of Ph-like ALL is 20% to 25% of adult ALL and 15% of pediatric ALL. Diagnosis of Ph+-ALL and Ph-like ALL is very important because TKI therapy can be helpful in most of these patients. This assay can determine most of the mutations, translocations, and expression of genes (CRLF2) associated with Ph+ ALL and Ph-like ALL.

Diffuse Large B-cell Lymphoma (DLBCL) and Other Types of Lymphoma or Plasma Cell Neoplasms: This assay can provide very valuable information for the management and monitoring of patients with DLBCL. It can distinguish between activated B-cell-like (ABC) and germinal center B-cell-like (GCB) and can help in the diagnosis of double hit lymphoma. The assay is also useful for other types of lymphoma, including follicular lymphoma and T-cell neoplasms, as well as multiple myeloma.

IgVH Mutation Status: Very important for prognosis and therapy selection in patients with chronic lymphocytic leukemia (CLL).

T-cell and B-cell Clonality Detection: The detection of T- and B-cell clonality is important because it can help diagnose and monitor certain types of malignancies. When a malignant transformation occurs in a T- or B-cell, the cells can undergo uncontrolled clonal expansion, resulting in the accumulation of a large number of identical cells with the same T- or B-cell receptor.

Epstein-Barr Virus (EBV): Important for diagnosis and classification of lymphoproliferative neoplasms.

Torque Teno Virus (TTV): This virus was first discovered in a patient with non-A-E hepatitis and is now regarded as a part of the human virome. In general, TTV does not cause pathology in immunocompetent individuals. This virus is considered as a marker of the degree of immune competence in patients with immunological impairment and inflammatory disorders. High TTV load is associated with increased risk of infection. In patients with organ transplant, low TTV load is associated with an increased risk of rejection.

Other Features of Hematology Profile Plus:
- HLA class I genotyping
-Enrichment for CD138-positive plasma cells is performed on bone marrow specimens with the clinical indication of multiple myeloma
-A preliminary report will be issued for any patient positive for FLT3-ITD by fragment analysis or with a clinical indication of acute leukemia

Hematology Profile Plus combines expression and fusion with mutation analysis in DNA and RNA. The test covers 284 DNA genes and more than 1600 RNA genes. This is a comprehensive evaluation for all hematologic neoplasms.

Synonyms
Turnaround Time
8-11 days
Methodology
Molecular
Specimen Requirements
  • Bone marrow: 2 mL. EDTA tube is preferred.
  • Peripheral blood: 5-10 mL. EDTA tube is preferred.
  • Fresh Tissue
  • FFPE: 1 H&E slide and 8-10 unstained slides, 5-7 microns of BM clot or tissue fixed with 10% NBF fixative. Alternatively, the FFPE block of the BM clot can be sent for sectioning in our Lab.

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Storage and Transportation

For FFPE samples:

  • If sending FFPE Block-Insert up to 6 blocks into plastic block tray provided. Insert block tray into foam insert in the transport box.
  • If sending slides-Insert slides into plastic slide holders provided. Insert the slide holders into the foam insert in the transport box.  The container will hold up to 6 maximum slide holders.
  • Place folded test requisition(s) and/or manifest(s) if ordered electronically into the transport kit.
  • Close box and tuck tabs into place. No tape necessary.

For blood samples:

  • Ship using a cold pack. The cold pack should not directly contact the blood tube. Ship as soon as sample collected with overnight delivery.

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CPT Codes
81455