Evaluation and classification of chronic neutrophilia
Aids in the diagnosis of chronic neutrophilic leukemia (CNL)
Identification of mutations that may suggest the class of kinase inhibitor to which the neoplasm may be sensitive
Mutation Detection in DNA Using Sanger Sequencing
Chronic neutrophilic leukemia
Neutrophilia
Myeloproliferative neoplasm colony-stimulating factor 3
Exons 14 and 17
Varies
Specimen must arrive within 10 days (240 hours) of collection.
The following information is required:
1. Pertinent clinical history
2. Clinical or morphologic suspicion
3. Date and time of collection
4. Specimen source
Question ID | Description | Answers |
---|---|---|
MP028 | Specimen Type |
Submit only 1 of the following specimens:
Specimen Type: Blood
Container/Tube: EDTA (lavender top) or ACD (yellow top)
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send specimen in original tube.
3. Label specimen as blood.
Specimen Stability Information: Ambient (preferred)/Refrigerate
Specimen Type: Bone marrow aspirate
Container/Tube: EDTA (lavender top) or ACD (yellow top)
Specimen Volume: 2 mL
Collection Instructions:
1. Invert several times to mix bone marrow.
2. Send specimen in original tube.
3. Label specimen as bone marrow.
Specimen Stability Information: Ambient (preferred)/Refrigerate
Specimen Type: Extracted DNA from blood or bone marrow
Container/Tube: 1.5- to 2-mL tube
Specimen Volume: Entire specimen
Collection Instructions: Label specimen as extracted DNA from blood or bone marrow and provide indication of volume and concentration of the DNA.
Specimen Stability Information: Frozen (preferred)/Refrigerate/Ambient
Specimen Type: Paraffin-embedded tissue
Container/Tube: Paraffin block
Specimen Stability Information: Ambient
Specimen Type: Paraffin-embedded bone marrow aspirate clot
Container/Tube: Paraffin block
Specimen Stability: Ambient
Specimen Type: Tissue
Slides: Unstained slides
Specimen Volume: 10 Slides
Specimen Stability Information: Ambient
1. Hematopathology Patient Information (T676) in Special Instructions
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.
Blood, bone marrow: 1 mL
Extracted DNA from blood or bone marrow: 50 microliters (mcL) at 20 ng/mcL
Gross hemolysis | Reject |
Other | Bone marrow core biopsies Paraffin shavings Frozen tissues Moderately to severely clotted |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Varies | 10 days |
Evaluation and classification of chronic neutrophilia
Aids in the diagnosis of chronic neutrophilic leukemia (CNL)
Identification of mutations that may suggest the class of kinase inhibitor to which the neoplasm may be sensitive
CSF3R encodes the receptor for colony-stimulating factor 3, a cytokine that controls the production, differentiation, and function of granulocytes. Somatic CSF3R mutations were recently described in 50% to 80% of chronic neutrophilic leukemia (CNL) patients. Their association with atypical chronic myelogenous leukemia (aCML) remains controversial. They have also been reported as somatic events in severe congenital neutropenia (SCN) patients.
There are 2 types of CSF3R mutations: extracellular domain/membrane proximal point mutations (most commonly p.T618I) and cytoplasmic tail truncation mutations. They demonstrated sensitivity to JAK kinase inhibitors and Src kinase inhibitors, respectively, in in vitro assays. In CNL, the most common mutation is p.T618I, although cytoplasmic truncation mutation can also occur. Somatic cytoplasmic truncation mutations have been reported in approximately 30% of SCN patients and 80% of SCN patients with leukemic transformation, who are often on granulocyte-colony stimulating factor (GCSF) therapy. However, their role in leukemic transformation is uncertain.
An interpretive report will be provided
The results will be given as positive or negative for CSF3R mutation and, if positive, the mutation will be described.
The assay is performed using Sanger sequencing, which has a sensitivity of 20%. This means that 20% or more of the DNA in the sample must be mutated to be detected.
A positive result can be seen in chronic neutrophilic leukemia (CNL). However, it is not specific for this neoplasm and clinicopathologic correlation is necessary in all cases.
A negative result does not exclude the presence of a CNL, other myeloproliferative neoplasms, or other hematologic or nonhematologic neoplasms.
1. Maxson JE, Gotlib J, Pollyea DA, et al: Oncogenic CSF3R mutations in chronic neutrophilic leukemia and atypical CML. N Engl J Med 2013;368:1781-1790
2. Pardanani A, Lasho TL, Laborde RR, et al: CSF3R T618I is a highly prevalent and specific mutation in chronic neutrophilic leukemia. Leukemia 2013;27:1870-1873
3. Tefferi A, Thiele J, Vannucchi AM, et al: An overview on CALR and CSF3R mutations and a proposal for revision of WHO diagnostic criteria for myeloproliferative neoplasms. Leukemia 2014;1:1-7
4. Vandenberghe P, Beel K: Severe congenital neutropenia, a genetically heterogeneous disease group with an increased risk of AML/MDS. Pediatr Rep 2011;3(s2):e9
Exons 14 and 17 of CSF3R are amplified from the extracted DNA by PCR, followed by Sanger sequencing and capillary electrophoresis analysis. Review of the sequence data is performed using a combination of automated calls and manual inspection.(Unpublished Mayo method)
Monday through Friday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
81479-Unlisted molecular pathology procedure
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
CSF3R | CSF3R Exon 14/17 Mutation Detection | 92674-1 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
39427 | CSF3R Sequencing Result | No LOINC Needed |
MP028 | Specimen Type | 31208-2 |
37924 | Final Diagnosis | 50398-7 |
Change Type | Effective Date |
---|---|
Obsolete Test | 2023-07-11 |