ALL Pediatric FISH Panel

The ALL Pediatric FISH Panel is used to detect recurrent chromosome abnormalities in pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL) and B lymphoblastic lymphoma (LBL). Identifying specific genetic abnormalities helps predict disease aggressiveness, prognosis, and response to therapy, guiding both risk stratification and treatment decisions.

This panel includes key probes relevant to pediatric disease biology, such as ETV6/RUNX1 t(12;21), a marker of favorable prognosis, and BCR/ABL1 t(9;22), a marker of Philadelphia chromosome-positive ALL. A positive result for ETV6/RUNX1 indicates a lower-risk disease with a better prognosis, while BCR/ABL1 t(9;22) signals a higher-risk, more aggressive disease that can be treated with tyrosine kinase inhibitors (TKIs) (Schneider et al., 2007; Reiter et al., 2003). MYC and MLL rearrangements, along with trisomies and tetrasomies of chromosomes 4, 6, 10, and 17, are also critical for assessing prognosis and informing treatment intensity (Yoshida et al., 2012; Pui et al., 2011).

This panel is designed specifically for pediatric patients and includes ETV6/RUNX1 t(12;21), which is absent in the ALL Adult FISH Panel due to its prevalence in pediatric cases. The information provided by this panel helps clinicians guide therapy choices, offering a more personalized approach to treatment and improving outcomes for pediatric patients.

Bone Marrow Aspirate: 1-2 mL in sodium heparin tube. EDTA tube is acceptable.
Peripheral Blood: 2-5 mL in sodium heparin tube. EDTA tube is acceptable.
Fresh, Unfixed Tissue: Tissue in RPMI.
Bone Marrow/Peripheral Blood Smear or Fresh Tissue Touch Preparation Slides: Minimum 8 slides, labeled with specimen type.
Fluids: Mix in equal parts with RPMI (specimen volume to RPMI ratio of 1:1).
Fixed Cell Suspension: A client-prepared fixed cell suspension is acceptable if received in 3:1 Methanol:Glacial Acetic Acid.