BCR/ABL1, p210, Quant, Monitor
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. BCR/ABL1, p210, Quant, Monitor | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
BCRAB
Test Workstation :
MAYO
Specimen Type:
Whole Blood or Bone Marrow
Tube Type:
Purple Top (EDTA)
Collection Volume:
10 ml EDTA Whole Blood or 3 ml EDTA Bone Marrow
Minimum Volume:
4.0 mL Blood, or 1 mL Bone Marrow
Cause for Rejection:
Grossly Hemolyzed
Storage:
Refrigerated
Availability:
Sent to reference laboratory
Methodology:
Quantitative, reverse transcription PCR (Cepheid Gene Expert)
Special Instructions:
Only collect specimens Monday through Thursday. Specimen must arrive at Mayo within 72 hours. Test performed at Mayo Monday through Friday only.
Lab/Phone:
330-543-8418
TAT:
3-6 days
CPT Code:
81206
Synonyms:
Acute lymphoblastic leukemia (ALL),
Acute myeloid leukemia (AML),
B lymphoblastic leukemia (BALL),
T lymphoblastic leukemia (TALL),
BCRABL1,
BCR ABL,
BCR/ABL,
Chronic myelogenous leukemia (CML),
Philadelphia chromosome, Ph bone marrow/blood t(9;22),
Tyrosine kinase inhibitor (TKI) therapy monitoring, PCR
