IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction)
CPT4 code
Name of the Procedure:
IGH@ (Immunoglobulin heavy chain locus) Gene Rearrangement Analysis, Amplified Methodology (PCR)
Summary
Immunoglobulin heavy chain locus gene rearrangement analysis is a test used to identify abnormal clonal B-cell populations, which are characteristic of certain leukemias and lymphomas. This specific procedure uses amplified methodology like polymerase chain reaction (PCR) to detect these gene rearrangements.
Purpose
The primary purpose of this test is to diagnose and monitor B-cell leukemias and lymphomas by detecting abnormal clonal populations. It helps in identifying the presence of malignant B-cells and aids in the prognosis and management of these conditions.
Indications
- Unexplained lymphadenopathy (swollen lymph nodes)
- Persistent B symptoms (fever, night sweats, weight loss)
- Abnormal blood counts indicating potential hematologic malignancy
- Monitoring disease progression or response to treatment in known B-cell leukemias or lymphomas
Preparation
- No special preparation is typically required for this test.
- A blood sample or tissue biopsy, such as from bone marrow or lymph nodes, may be needed.
- Follow your physician's instructions regarding any medications or dietary restrictions.
Procedure Description
- Sample Collection: Blood sample or tissue biopsy is collected.
- DNA Extraction: DNA is extracted from the collected sample.
- PCR Amplification: Specific regions of the immunoglobulin heavy chain gene are amplified using polymerase chain reaction (PCR).
- Analysis: The amplified DNA is analyzed to detect clonal rearrangements indicative of abnormal B-cells.
- Tools/Technology: PCR machine, electrophoresis equipment.
- No anesthesia or sedation is required.
Duration
The procedure typically takes a few hours to complete including sample processing, PCR amplification, and analysis.
Setting
The procedure is performed in a clinical laboratory setting.
Personnel
- Laboratory technician or medical technologist
- Pathologist or specialist in hematology/oncology for result interpretation
Risks and Complications
- Minimal risks as it involves routine blood draw or biopsy.
- Rare complications might include infection or bleeding at the biopsy site.
Benefits
- Early and accurate diagnosis of B-cell leukemias and lymphomas
- Effective monitoring of disease progression or response to treatment
- Guide to appropriate therapeutic interventions
Recovery
- No special recovery required; patients can resume normal activities immediately after the sample collection.
- Follow any specific instructions provided for biopsy care if a tissue sample was taken.
Alternatives
- Flow cytometry: Useful for identifying and characterizing cell populations.
- Cytogenetic Analysis: Helps in identifying chromosome abnormalities related to different types of cancer.
- Pros and Cons: Flow cytometry is quicker but may not be as specific; cytogenetic analysis provides broad genetic information but is slower and more labor-intensive.
Patient Experience
- During: You may feel a slight pinch during blood draw or biopsy, but the discomfort is usually minimal.
- After: There might be minor soreness at the site of sample collection; over-the-counter pain relief can be used if necessary.
- Pain management: Generally, not required; local anesthesia may be used if a tissue biopsy is involved.