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T-Cell Gene Rearrangements by PCR

Detects T-cell clonality in blood, bone marrow, body fluid cells and paraffin-embedded tissue. May be used to monitor minimal residual disease. Sensitivity: 1-5 abnormal cells per 100. Detects the majority of T-cell receptor gamma subunit (TCR) gene rearrangements. Clinical sensitivity 90-95%.

CPT Codes:

83891(1), 83901(8), 83900(1), 83909(4), 83912(1)

Specimen Requirements:
  1. Peripheral Blood:
    • 1-2 ml aseptically aspirated in EDTA (lavender-top) tube.
    • Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
  2. Bone Marrow Aspirate:
    • 2-3 ml aseptically aspirated in EDTA (lavender-top) tube.
    • Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
    • Provide bone marrow smear and CBC results.
  3. Fresh Tissue Biopsy:
    • Minimum of 0.2 cm3 in transport medium. Do not use transport medium if it turns cloudy, yellow or is beyond the expiration date. Use only pink/orange color media.
    • Refrigerate specimen. Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.
  4. Frozen Tissue Biopsy:
    • Tissue quickly frozen in a cryostat. Optimal Cutting Temperature (OCT) compound is acceptable if flash freezing equipment is not available.
    • Minimum of 0.2 cm3 snap frozen.
    • Store specimen at -20º C. Ship on minimum of 10 lbs dry ice.
  5. Fixed Paraffin Block with Corresponding H&E:
    • Neutral buffered formalin-fixed tissue required.
    • Minimum tissue size of 0.2 cm3.
    • Store specimen at room temperature (20-23.5° C).
  6. Body Fluids:
    • In order to ensure adequate cellularity for a comprehensive evaluation, a white blood count (WBC) should be performed on the specimen prior to sending. If the WBC and lymphocyte counts are similar to that of peripheral blood (5 x 106 cells/μL with 20-30% lymphocytes), 25-100 ml of fluid will provide sufficient cells. The fluid volume should be adjusted upward proportionately if the WBC and lymphocyte counts are lower.
    • Evacuated bottle or collection pouch.
    • 25-100 ml fluid in 1:1 dilution transport medium. Do not use transport medium if it turns cloudy, yellow or is beyond the expiration date. Use only pink/orange color media.
    • Refrigerate specimen. Use cold pack for transport. Be sure cold pack is not in direct contact with specimen during transport.

Turnaround Time:

8-10 days

Client Services: Oncology/Pathology   800-447-5816

Specimen Services/Pickup:  877-246-1226