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PML-RARA t(15;17), Quantitative Real-Time PCR

Test Summary

This assay detects the short form (bcr3), long form (bcr1) and the variant exon 6 (bcr2) PML-RARA transcripts associated with the t(15; 17) chromosomal translocation. PML-RARA transcript levels are expressed as normalized copy number (NCN) of PML-RARA using ABL1 as internal control. The lower limit of PML-RARA + leukemia detection in this assay is dependent on the quality of RNA obtained and the cellularity of the sample. Analytic assay sensitivity is determined at 1:100,000.

Various clinical regimens combining all-trans retinoic acid (ATRA), arsenic trioxide (ATO) and anthracyclines now cure the majority of APL patients. ATRA induces APL differentiation and transient remissions. ATO targets PML through oxidation-triggered disulphide bond formation and direct binding, resulting in PML-RARA sumoylation, ubiquitylation and proteasome-mediated degradation (Lallemand-Breitenbach et al. 2012).

Aliases

  • N/A

Specimen Collection

Special Instructions

N/A

Preferred Specimen

5 mL whole blood or 3 mL bone marrow collected in an EDTA (lavender-top) tube

Minimum Volume

3 mL whole blood • 1 mL bone marrow • 20 uL of 10 ng/uL extracted RNA

Instructions

Do not reject specimens, send to laboratory for screening.

Collect 5 mL of whole blood or 3 mL bone marrow in an EDTA (lavender-top) tube. Whole blood or bone marrow is shipped at room temperature or refrigerated (cold packs). Do not freeze whole blood or bone marrow.
After collection of the sample, draw date and time, as well as sample type, must be written on the tube and included as requested information.
If the stability of the sample cannot be determined, delay in result or cancelation of test may occur. Clotted specimens are unacceptable.

Only accept extracted RNA when extraction or isolation is performed in an appropriately qualified laboratory such as a CLIA-certified laboratory or a laboratory meeting equivalent requirements as determined by the CAP and/ or CMS.


Patient Preparation

N/A

Storage

N/A

Transport Temperature

Whole blood or bone marrow: Room temperature
Extracted RNA: Refrigerated (cold packs)

Specimen Stability

  • Whole blood and Bone marrow
  • Room temperature: 5 days
  • Refrigerated: 5 days
  • Frozen: Unacceptable
  • Extracted RNA
  • Room temperature: Unacceptable
  • Refrigerated: Preferred
  • Frozen: Acceptable

Limitations

N/A

Other Acceptable Specimens

Whole blood or bone marrow collected in: sodium heparin (green-top) tube, or ACD-B solution (yellow-top) tube • 50 uL of 10 ng/uL extracted RNA submitted in a microcentrifuge tube

Unacceptable Specimens

N/A

Order Code

PMLRAQ

EPIC (Premier) Code

LAB3207

Includes

N/A

CPT Code

  • 81315

Billing Code

  • 670854

CPT Statement

Methodology

Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)

FDA Status

This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Physician Attestation of Informed Consent

N/A

Testing Laboratory

Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly VA, 20153

Department

Reference Testing

Reference Range

See Laboratory Report

Setup Schedule / Expected Turnaround Time

Daily; Report available: 5 days

Specimen Collection

Special Instructions

N/A

Preferred Specimen

5 mL whole blood or 3 mL bone marrow collected in an EDTA (lavender-top) tube

Minimum Volume

3 mL whole blood • 1 mL bone marrow • 20 uL of 10 ng/uL extracted RNA

Instructions

Do not reject specimens, send to laboratory for screening.

Collect 5 mL of whole blood or 3 mL bone marrow in an EDTA (lavender-top) tube. Whole blood or bone marrow is shipped at room temperature or refrigerated (cold packs). Do not freeze whole blood or bone marrow.
After collection of the sample, draw date and time, as well as sample type, must be written on the tube and included as requested information.
If the stability of the sample cannot be determined, delay in result or cancelation of test may occur. Clotted specimens are unacceptable.

Only accept extracted RNA when extraction or isolation is performed in an appropriately qualified laboratory such as a CLIA-certified laboratory or a laboratory meeting equivalent requirements as determined by the CAP and/ or CMS.


Patient Preparation

N/A

Storage

N/A

Transport Temperature

Whole blood or bone marrow: Room temperature
Extracted RNA: Refrigerated (cold packs)

Specimen Stability

  • Whole blood and Bone marrow
  • Room temperature: 5 days
  • Refrigerated: 5 days
  • Frozen: Unacceptable
  • Extracted RNA
  • Room temperature: Unacceptable
  • Refrigerated: Preferred
  • Frozen: Acceptable

Limitations

N/A

Other Acceptable Specimens

Whole blood or bone marrow collected in: sodium heparin (green-top) tube, or ACD-B solution (yellow-top) tube • 50 uL of 10 ng/uL extracted RNA submitted in a microcentrifuge tube

Unacceptable Specimens

N/A

Billing

CPT Code

  • 81315

Billing Code

  • 670854

CPT Statement

Result Information

Methodology

Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)

Testing Laboratory

N/A

Reference Range

See Laboratory Report

Setup Schedule / Expected Turnaround Time

Daily; Report available: 5 days