Test Catalog

Test ID: LPLFX    
Lymphoplasmacytic Lymphoma/Waldenstrom Macroglobulinemia (LPL/WM), MYD88 L265P with Reflex to CXCR4

Useful For Suggests clinical disorders or settings where the test may be helpful

Establishing the diagnosis of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (LPL/WM)


Helping distinguish LPL/WM low-grade B-cell lymphoma from other subtypes


Aiding in the prognostication and clinical management of LPL/WM


The MYD88 L265P abnormality is highly associated (>90%) with the pathologic diagnosis of lymphoplasmacytic lymphoma and the clinical syndrome of Waldenstrom macroglobulinemia (LPL/WM), particularly in the setting of an elevated IgM serum monoclonal paraprotein.


CXCR4 mutations are identified in approximately 30% to 40% of LPL/WM and are almost always in association with MYD88 L265P, which is highly prevalent in this neoplasm. The status of CXCR4 mutations in the context of MYD88 L265P is clinically relevant as important determinants of clinical presentation, overall survival and therapeutic response to ibrutinib. This test is used to aid in the prognostication and therapeutic management of LPL/WM. It offers highly sensitive detection of the well-characterized hotspot mutations c.1013C->G/A, p.S338X and routine Sanger sequencing for other mutations in the C-terminus region.

Reflex Tests Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test IDReporting NameAvailable SeparatelyAlways Performed
CXCFXCXCR4, Gene Mutation, ReflexNo, (bill only)No

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

DNA will be extracted. The algorithm starts with the sensitive MYD88 L265P testing by allele-specific polymerase chain reaction (PCR.) If a MYD88 L265P mutation is detected, additional CXCR4 testing will be performed. If a MYD88 L265P mutation is not detected, the algorithm ends and no further testing will be performed.

Special Instructions Library of PDFs including pertinent information and forms related to the test

Method Name A short description of the method used to perform the test

Allele-Specific Polymerase Chain Reaction (AS-PCR), Bridged Nucleic Acids (BNA) Clamp Sanger Sequencing and Routine Sanger Sequencing

(BNAClamp is utilized pursuant to a license agreement with BNA Inc.)

NY State Available Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name Lists a shorter or abbreviated version of the Published Name for a test

Reflex Testing of MYD88 and CXCR4

Aliases Lists additional common names for a test, as an aid in searching

B-cell lymphoma
Lymphoplasmacytic lymphoma
Waldenstrom Macroglobulinemia