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Test ID: IMRGF Imatinib Mesylate Responsive Genes, FISH, Varies

Useful For

Detecting a neoplastic clone associated with the common chromosome abnormalities seen in patients with acute leukemia or other myeloid malignancies


Tracking known chromosome abnormalities and response to therapy in patients with myeloid malignancies

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_PBCT Probe, +2 No, (Bill Only) No
_PADD Probe, +1 No, (Bill Only) No
_PB02 Probe, +2 No, (Bill Only) No
_PB03 Probe, +3 No, (Bill Only) No
_IL25 Interphases, <25 No, (Bill Only) No
_I099 Interphases, 25-99 No, (Bill Only) No
_I300 Interphases, >=100 No, (Bill Only) No

Testing Algorithm

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results.


Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.


This assay includes testing for the following abnormalities using the probes listed:

ABL2 (1q25) rearrangement

FIP1L1/CHIC2/PDGFRA (4q12) rearrangement (CHIC2 deletion)

PDGFRB (5q33) rearrangement

ABL1 (9q34) rearrangement


If an ABL1 rearrangement is identified, reflex testing will be performed using the BCR/ABL1 dual-color, double fusion FISH probe set to evaluate for the presence or absence of BCR/ABL1 fusion.


If the patient is being tracked for known abnormalities, indicate which probes should be used.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

Imatinib Mesylate Resp Genes, FISH

Specimen Type


Shipping Instructions

Advise Express Mail or equivalent if not on courier service.

Necessary Information

Provide a reason for referral with each specimen. The laboratory will not reject testing if this information is not provided, but appropriate testing and interpretation may be compromised or delayed.

Specimen Required

Submit only 1 of the following specimens:


Specimen Type: Whole blood

Container/Tube: Green top (sodium heparin)

Specimen Volume: 7-10 mL

Collection Instructions:

1. Invert several times to mix blood.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.


Specimen Type: Bone marrow

Container/Tube: Green top (sodium heparin)

Specimen Volume: 1-2 mL

Collection Instructions:

1. Invert several times to mix bone marrow.

2. Other anticoagulants are not recommended and are harmful to the viability of the cells.

Specimen Minimum Volume

Blood: 2 mL
Bone Marrow: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)

Clinical Information

Myeloid neoplasms are primary disorders of the bone marrow cells. These malignancies encompass several entities with extremely varied clinical courses, including acute myeloid leukemias (AML), chronic myeloproliferative disorders (CMPD), and myelodysplastic syndromes. The underlying genetic mechanisms associated with these malignancies are varied and only a portion of the genetic abnormalities have targeted therapies clinically available.


One group of genes, including ABL1 (Abelson murine leukemia viral oncogene homolog 1), ABL2 (Abelson murine leukemia viral oncogene homolog 2), PDGFRA (platelet-derived growth factor receptor, alpha), and PDGFRB (platelet-derived growth factor receptor, beta) can be inappropriately activated via various genetic mechanisms and result in overexpression of their tyrosine kinase activity. Tyrosine kinase activity plays an important role in cellular signaling, division, and differentiation; overexpression may cause some cancers. The myeloid malignancies associated with these aberrantly expressed genes include AML, chronic myelogenous leukemia (CML), hypereosinophilic syndrome/systemic mast cell disease (HES/SMCD), and atypical CMPD. These translocations can also be seen in lymphoid neoplasms, including acute lymphoblastic leukemia (ALL) and lymphomas, and they can also possess a varied genetic etiology. Several clinical studies have demonstrated that the malignancies displaying overexpression of these genes are responsive to imatinib mesylate, a drug that specifically targets these genes.

Reference Values

An interpretive report will be provided.


A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal cutoff for any given probe.


The presence of a positive clone supports a diagnosis of malignancy.


The absence of an abnormal clone does not rule out the presence of neoplastic disorder.

Clinical Reference

1. Trempat P, Villalva C, Laurent G, et al: Chronic myeloproliferative disorders with rearrangement of the platelet-derived growth factor alpha receptor; a new clinical target for STI571/Glivec. Oncogene 2003 Aug 28;22(36):5702-5706

2. Dave BJ, Wiggins M, Higgeins CM, et al: 9q34 rearrangements in BCR/ABL fusion-negative acute lymphoblastic leukemia. Cancer Genet Cytogenet 2005 Oct 1;162:30-37

3. Pardanani A, Reeder T, Porrata LF, et al: Imatinib therapy for hypereosinophilic syndrome and other eosinophilic disorders. Blood 2003 May 1;101(9):3391-3397

4. Pardanani A, Tefferi A: Imatinib targets other than bcr/abl and their clinical relevance in myeloid disorders. Blood 2004 Oct 1;104(7):1931-1939

Day(s) and Time(s) Performed

Samples processed Monday through Sunday. Results reported Monday through Friday, 8 a.m.-5 p.m. CST.

Analytic Time

7 days

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

88271 x 2, 88291-DNA probe, each (first probe set), Interpretation and report

88271 x 2-DNA probe, each; each additional probe set (if appropriate)

88271 x 1-DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271 x 2-DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271 x 3-DNA probe, each; coverage for sets containing 5 probes (if appropriate)

88274 w/modifier 52-Interphase in situ hybridization, <25 cells, each probe set (if appropriate)

88274-Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)

88275-Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
IMRGF Imatinib Mesylate Resp Genes, FISH In Process


Result ID Test Result Name Result LOINC Value
51811 Result Summary 50397-9
51813 Interpretation 69965-2
51812 Result Table 93356-4
54532 Result 62356-1
CG659 Reason for Referral 42349-1
CG660 Specimen 31208-2
51814 Source 31208-2
51815 Method 49549-9
53430 Additional Information 48767-8
55276 Disclaimer 62364-5
51816 Released By 18771-6


If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

Mayo Clinic Laboratories | Hematology Catalog Additional Information:

mml-acute-leukemia-myelodysplastic-syndromes, mml-myeloproliferative-neoplasm