CLL MRD Flow Panel

CLL Minimal Residual Disease Panel

Methodology

Flow Cytometry

Test Description

Available as global test only. Markers are CD3, CD5, CD19, CD20, CD22, CD43, CD45, CD79b, and CD81 (9 markers).

Clinical Significance

Monitoring of minimal residual disease (MRD) in chronic lymphocytic leukemia (CLL) has become increasingly important as treatments improve. This flow cytometry panel follows the strategy developed by the European Research Initiative in CLL (ERIC) and can detect MRD at the 0.01% level. Detection of MRD above 0.01% is reported to be an independent predictor of progression-free survival and overall survival in CLL patients treated with chemoimmunotherapy. The prognostic value of achieving MRD-negative status with other CLL therapies is under investigation in clinical trials.

References

1. Rawstron AC, Fazi A, Agathangelidis A, et al. A complementary role of multiparameter flow cytometry and high-throughput sequencing for MRD detection in CLL: an European Research Initiative on CLL study. Leukemia. 2016;30:929-936.

2. Rawstron AC, Bottcher S, Letestu R, et al. Improving efficiency and sensitivity: European Research Initiative in CLL (ERIC) update on the international harmonised approach for flow residual disease monitoring in CLL. Leukemia. 2013;27:142-149.

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. 
  • Bone marrow core: 1-2 cm minimum core length in RPMI. 
  • Fresh, unfixed tissue: 0.2 cm3 minimum in RPMI. 
  • Fluids and FNAs: Equal parts RPMI and specimen.

Storage & 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)*

88184(x1), 88185(x8). Add 88188(x1) for global.

Level of Service

  • Global   

Turnaround Time

1 day


*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.


 

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