Alternative Name
B-ALL Minimal Residual Disease Panel
Methodology
Flow Cytometry
Test Description

Available as global test only. Markers are CD3, CD9, CD10, CD13/CD33, CD19, CD20, CD34, CD38, CD45, CD58, CD71, and Syto16 (13 markers; Syto16 is not reported). This panel can detect MRD at the 0.01% level.

Clinical Significance

In patients with B-lymphoblastic leukemia, a combination of morphology and flow cytometry testing for minimal residual disease (MRD) is recommended when assessing response to therapy [1].  In both adult and pediatric patients with acute lymphoblastic leukemia, MRD during standard ALL chemotherapy is the strongest overall prognostic indicator and has therefore been used for refining initial treatment stratification [2, 3]. MRD positivity after the maintenance phase of treatment, pretransplant or post stem cell transplantation also provides prognostic information that may help guide therapeutic interventions [3]. This flow cytometry panel follows a consensus strategy and can detect MRD at the 0.01% level.

Specimen Requirements
Bone marrow aspirate or peripheral blood: 1-2 mL EDTA preferred. 1-2 mL minimum in sodium heparin tube or ACD (pale yellow/no gel separator) is acceptable. Please provide recent CBC report. 
Storage and Transportation

Specimens should be received at NeoGenomics within 72 hours from collection to assure sample integrity and acceptable cell viability. Ship same day as drawn whenever possible. Refrigerate specimen. Do not freeze. Use cold pack for transport, making sure cold pack is not in direct contact with specimen.

CPT Code(s)*
88184x1, 88185x10. Add 88188x1 for global.
Turnaround Time

1 day

References
1. Gupta S, Devidas M, Loh ML, et al. Flow-cytometric vs. morphologic assessment of remission in childhood acute lymphoblastic leukemia: a report from the Children's Oncology Group (COG). Leukemia. 2018;32(6):1370-1379.
2. Borowitz MJ, Wood BL, Devidas M, et al. Prognostic significance of minimal residual disease in high risk B-ALL: a report from Children's Oncology Group study AALL0232. Blood2015;126(8):964-71.
3. Brüggemann M, Kotrova M. Minimal residual disease in adult ALL: technical aspects and implications for correct clinical interpretation. Blood Adv. 2017;1(25):2456-2466.
Level of Service
Global

*The CPT codes provided with our test descriptions are based on AMA guidelines and are for informational purposes only. Correct CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed.