Panel Description

Leukemia
Lymphoma
Myelodysplastic syndrome
Bone Marrow Failure
The Hematologic Malignancy Comprehensive Panel examines 16 genes associated with bone marrow failure or cancers of the blood. These genes include those associated with specific syndromes, as well as those associated with familial susceptibility in the absence of other clinical findings.

Patients with a personal or family history suggestive of a hereditary hematologic malignancy, which could include progressive bone marrow failure, leukemia, lymphoma, myelodysplastic syndrome as well as physical findings or other health issues suggestive of a genetic syndrome. After consideration of a patient’s clinical and family history, this testing may be appropriate for some pediatric patients. (If there are specific genes that you do NOT want included, please indicate this on the test requisition form.) This test is designed to detect individuals with a germline pathogenic variant, and is not validated to detect mosaicism below the level of 20%. It should not be ordered on tumor tissue.

Patients identified with a hereditary susceptibility to hematologic cancer or bone marrow failure can benefit from increased surveillance and preventative steps to better manage their risks. Knowing the genetic cause of the hematologic abnormalities in an individual also reveals the inheritance pattern within a family. As a result, your patient’s family members can be tested to help define the risk to themselves and their families. Because preventative action and surveillance should begin in childhood for some genes included in this panel, testing of minors may be appropriate.

Test Description

  • Sequencing
  • Del/Dup
  • Rush / STAT
  • Exclude VUS
2 – 3 weeks
Call for details
ATM, BLM, CEBPA, EPCAM, GATA2, HRAS, MLH1, MSH2, MSH6, NBN, NF1, PMS2, RUNX1, TERC, TERT, TP53 ( 16 genes )
99% at 50x
DNA extracted from cultured fibroblasts should be submitted instead of blood/saliva/buccal samples from individuals who have undergone allogeneic bone marrow transplant and from patients with hematologic malignancy.​
Test results and variant interpretation are based on the proper identification of the submitted specimen and use of correct human reference sequences at the queried loci. In very rare instances, errors may result due to mix-up or co-mingling of specimens. Positive results do not imply that there are no other contributions, genetic or otherwise, to the patient’s phenotype, and negative results do not rule out a genetic cause for the indication for testing. Official gene names change over time. Fulgent uses the most up to date gene names based on HUGO Gene Nomenclature Committee (https://www.genenames.org) recommendations. If the gene name on report does not match that of ordered gene, please contact the laboratory and details can be provided. Result interpretation is based on the collected information and Alamut annotation available at the time of reporting. This assay is not designed or validated for the detection of mosaicism. DNA alterations in regulatory regions or deep intronic regions (greater than 20bp from an exon) will not be detected by this test. There are technical limitations on the ability of DNA sequencing to detect small insertions and deletions. Our laboratory uses a sensitive detection algorithm, however these types of alterations are not detected as reliably as single nucleotide variants. Rarely, due to systematic chemical, computational, or human error, DNA variants may be missed. Although next generation sequencing technologies and our bioinformatics analysis significantly reduce the confounding contribution of pseudogene sequences or other highly-homologous sequences, sometimes these may still interfere with the technical ability of the assay to identify pathogenic variant alleles in both sequencing and deletion/duplication analyses. Deletion/duplication analysis can identify alterations in genomic regions and is evaluated at a single exon resolution level in relevant genes associated with the patient’s clinical presentation. For custom added genes and applicable genes that may be of interest, deletion/duplication analysis is evaluated at a resolution of two or more contiguous exons. When novel DNA duplications are identified, it is not possible to discern the genomic location or orientation of the duplicated segment, hence the effect of the duplication cannot be predicted. Where deletions are detected, it is not always possible to determine whether the predicted product will remain in-frame or not. Unless otherwise indicated, in regions that have been sequenced by Sanger, deletion/duplication analysis has not been performed. Patients with Bone Marrow Transplants: DNA extracted from cultured fibroblasts should be submitted instead of blood/saliva/buccal samples from individuals who have undergone allogeneic bone marrow transplant and from patients with hematologic malignancy.

Gene Notes
MSH2 Inversion of MSH2 exons 1-7 (“Boland” inversion) is assessed for Lynch Syndrome, Colorectal, Endometrial, and Prostate Cancer Panel testing (for both Focus and Comprehensive Panels) as well as Comprehensive Gastric Cancer Panel testing. Unless otherwise specified, this testing is not performed for other cancer panels, but is available upon request.

Resources

DescriptionDownload
Hereditary Hematologic Malignancy Genetic Testing Information for Patients
Genetic Testing for Hereditary Cancers Webinar