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HelpOrder Code CHIMS Chimerism Transplant Sorted Cells, Varies
Useful For
Determining the relative amounts of donor and recipient cells in a specimen in sorted cell fractions
An indicator of bone marrow transplant success
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SORT1 | Chimerism Cell Sort 1 | No, (Bill Only) | No |
| SORT2 | Chimerism Cell Sort 2 | No, (Bill Only) | No |
Testing Algorithm
Complete chimerism analysis requires 3 specimens, under 3 separate orders, for the 3 separate tests listed below. These specimens should be submitted when collected. An interpretive report will be provided once all specimens are received.
Pre-Transplant:
-CHRGB / Chimerism-Recipient Germline (Pretransplant), Varies
-CHIDB / Chimerism-Donor, Varies
-ADONO / Additional Chimerism Donor (Bill Only), if applicable
Post-Transplant:
-CHIMU / Chimerism Transplant No Cell Sort, Varies or CHIMS / Chimerism Transplant Sorted Cells, Varies
Billing occurs with the following tests:
Pre-transplant:
-CHRGB / Chimerism-Recipient Germline (Pretransplant), Varies
-ADONO / Additional Chimerism Donor (Bill Only), if applicable
Post-Transplant:
-CHIMU / Chimerism Transplant No Cell Sort, Varies
-CHIMS / Chimerism Transplant Sorted Cells, Varies
-SORT1 / Chimerism Cell Sort 1 (Bill Only)
-SORT2 / Chimerism Cell Sort 2 (Bill Only)
For more information see Chimerism-Recipient Germline Testing Algorithm
Special Instructions
Method Name
Polymerase Chain Reaction (PCR) Amplification/Capillary Electrophoresis
Reporting Name
Chimerism Transplant Sorted CellsSpecimen Type
VariesOrdering Guidance
This test is used to determine the relative amounts of donor and recipient cells in the recipient post-bone marrow transplant specimen. Sorted cell analysis permits more detailed evaluation of chimeric status in T-cell and myeloid cell fractions. For post-bone marrow transplant evaluation of the recipient specimen, see CHIMU / Chimerism Transplant No Cell Sort, Varies
Additional Testing Requirements
Shipping Instructions
1. Specimen must arrive within 4 days of collection.
2. Collect and package specimen as close to shipping time as possible.
Necessary Information
Specimen Type is required, either as an answer to the Order Questions or on Chimerism Analysis Information (T594) if not ordering electronically. Testing will be delayed if this information is not provided.
Specimen Required
Submit only 1 of the following specimens:
Specimen Type: Blood
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD)
Specimen Volume: 4 mL
Collection Instructions:
1. Only 1 tube is required.
2. Invert several times to mix blood.
3. Label specimen as blood.
4. Send whole blood specimen in original tube. Do not aliquot.
Specimen Type: Bone marrow
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD)
Specimen Volume: 2 mL
Collection Instructions:
1. Invert several times to mix bone marrow.
2. Label specimen as bone marrow.
3. Send bone marrow specimen in original tube. Do not aliquot.
Specimen Minimum Volume
Blood: 3 mL
Bone marrow: See Specimen Required
Lesser volumes may be acceptable, depending on white cell count.
Call 800-533-1710 or 507-266-5700 with questions.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | 4 days | PURPLE OR PINK TOP/EDTA |
| Refrigerated | 4 days | PURPLE OR PINK TOP/EDTA |
Reject Due To
| Gross hemolysis | Reject |
| Moderately to severely clotted | Reject |
Reference Values
An interpretive report will be provided.
Method Description
Genomic DNA is extracted using an automated extraction platform and is then used in a commercial GlobalFiler polymerase chain reaction (PCR) Amplification Kit, following the manufacturer's instructions. Briefly, 20 different short tandem repeat (STR) marker regions are amplified in single multiplex PCR using primers labeled with fluorescent tags. The products are analyzed for size and amount using capillary electrophoresis. For the initial sample on any patient, the test is performed on 3 separate DNA samples: donor germline DNA, recipient germline DNA, and recipient posttransplant sample for chimerism determination. The STR profile of the germline samples is used to identify markers that can distinguish between the donor and recipient. Based on these profiles, the percentage of donor and recipient DNA is then determined in the posttransplant sample using the assumptions and calculations outlined in Thiede C et al. Subsequent samples for chimerism evaluation do not need to be accompanied by samples for donor and recipient germline evaluation, as the profiles from the initial testing are kept on file for comparison.
The sensitivity of this analysis is approximately 5% in a post-transplant specimen (donor and recipient DNA mixed chimerism).(Thiede C, Florek M, Bornhauser M, et al: Rapid quantification of mixed chimerism using multiplex amplification of short tandem repeat markers and fluorescence detection. Bone Marrow Transplant. 1999 May;23[10]:1055-1060; package insert: GlobalFiler PCR Amplification Kit. ThermoFisher Scientific; 08/21/2019)
Day(s) Performed
Monday through Friday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81268-Chimerism (engraftment) analysis, post hematopoietic stem cell transplantation specimen, includes comparison to previously performed baseline analyses; with cell selection (eg, CD3, CD33), each cell type (if appropriate)
Forms
1. Chimerism Analysis Information Sheet (T594)
2. If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.