Browsing Tag

May 2018

Advanced Technology Laboratory, Molecular Diagnostics

Methods update on BCR-ABL1 t[9;22] RT-PCR testing

An updated BCR-ABL1 t[9;22] RT-PCR assay went live on Jan 31, 2018. The BCR-ABL major and minor fusion transcripts are measured and reported separately after this update. The quantities of BCR-ABL1 major breakpoints fusion transcripts (type e13a2 and/or e14a2) are detected by FDA approved QuantideX® qPCR BCR-ABL IS Kit and the result is calibrated and reported on the International Scale (%IS). The quantities of BCR-ABL minor fusion transcripts are detected by QuantideX qPCR BCR-ABL minor kit and the result is reported as BCR-ABL1 to ABL1 ratio (%). This update provides more precise and standard measurements of BCR-ABL fusion RNA and supports the consistency of patient care in t(9;22) positive CML patients during monitoring of treatment with Tyrosine Kinase Inhibitors (TKIs).

Questions may be directed to the Molecular Diagnostics Laboratory using the “Contact Us” link above.

Lab Catalog link: LAB3222022: BCR-ABL1 t[9;22] RT- PCR  

Referral/Sendouts, Toxicology

Toxicology Testing Updates – May 2018

As of May 8, 2018, the following tests are no longer performed by Spectrum Health Laboratory. These tests are now available through Mayo Medical Laboratories as a send out. Please note that the specimen collection for these tests may have changed. Please check the Laboratory Catalog for collection information.

Discontinued Test Code Discontinue Test Name Replacement Code Replacement Name
LAB752 Clomipramine Level LAB1230481 Clomipramine, Serum
LAB683 Ethosuximide Level LAB1230480 Ethosuximide, Serum

Questions may be directed to the Toxicology Department using the “Contact Us” link above.

Chemistry, Referral/Sendouts, Test Utilization

Appropriate Thyroglobulin Tumor Marker and Anti-Thyroperoxidase Ordering Practices

Thyroid Peroxidase Antibody (anti-TPO), Blood Level (Test #8524 )
This is the recommended test for the evaluation of Autoimmune Thyroiditis

Thyroglobulin, Tumor Marker, Serum (Test #3069)
It is only indicated for monitoring of thyroid cancer treatment.
This result is reported with an Anti-Tg result to assess for possible interference.
This test should NOT be ordered for associated anti-Tg result provided by reference laboratory.

Thyroglobulin Antibody (anti-Tg) Test
Historically ordered with anti-TPO for evaluation of possible autoimmune thyroiditis.
The literature shows that anti-TPO, alone, has better sensitivity and specificity with only 5% of cases of Autoimmune thyroiditis with anti-TPO negative, anti-Tg positive.
Since 2/2011, requests for anti-Tg have been cancelled per Laboratory Communication: Memo Thyroglobulin Antibody 2/2011

Spectrum Health Regional Laboratory Experience February 2015 – March 2016 (13 months):
357 patients with both Anti-TPO and Anti-Tg results.
*Anti-Tg results were due to concomitantly ordered Thyroglobulin TM requests.
250 patients had positive Anti-TPO and/or Anti-Tg level
193 patients had both positive Anti-TPO and Anti-Tg level
56 patients had positive Anti-TPO and negative Anti-Tg level
1 patient had a negative Anti-TPO and positive Anti-Tg levels

Based on these results, and what is reported in the literature, we are confident of our current practices and strongly request discontinuation of Thyroglobulin TM requests for the associated Anti-Tg result

Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014 Apr-May;13(4-5):391-7