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HelpOrder Code reflex only CALX CALR Mutation Analysis, Myeloproliferative Neoplasm (MPN), Reflex, Varies
Additional Codes
MAYO CODE CALX
Reporting Name
CALR, Gene Mutation, Exon 9, ReflexSpecimen Type
VariesSpecimen Required
Only orderable as a reflex. For more information see MPNR / Myeloproliferative Neoplasm, JAK2 V617F with Reflex to CALR and MPL, Varies.
Submit only 1 of the following specimens:
Specimen Type: Whole Blood
Container/Tube: Lavender top (EDTA) or yellow top (ACD solution B)
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
3. Label specimen as blood.
Specimen Stability Information: Ambient (preferred)7 days/Refrigerate 7 days
Specimen Type: Bone marrow
Container/Tube: Lavender top (EDTA) or yellow top (ACD solution B)
Specimen Volume: 2 mL
Collection Instructions:
1. Invert several times to mix bone marrow.
2. Send bone marrow specimen in original tube. Do not aliquot.
3. Label specimen as bone marrow.
Specimen Stability Information: Ambient (preferred)7 days/Refrigerate 7 days
Specimen Type: Extracted DNA from blood or bone marrow
Container/Tube: 1.5- to 2-mL tube
Specimen Volume: Entire specimen
Collection Instructions:
1. Label specimen as extracted DNA from blood or bone marrow.
2. Provide volume and concentration of the DNA on the label.
Specimen Stability Information: Frozen (preferred)/Refrigerate/Ambient
Specimen Minimum Volume
Whole blood/Bone marrow: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Varies | 7 days |
Reference Values
Only orderable as a reflex. For more information see MPNR / Myeloproliferative Neoplasm, JAK2 V617F with Reflex to CALR and MPL, Varies.
An interpretive report will be provided.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81219-CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common variants in exon 9
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CALX | CALR, Gene Mutation, Exon 9, Reflex | 77174-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36998 | Final Diagnosis | 22637-3 |
Method Name
Only orderable as a reflex. For more information see MPNR / Myeloproliferative Neoplasm, JAK2 V617F with Reflex to CALR and MPL, Varies.
Polymerase Chain Reaction (PCR) and Fragment Analysis
Useful For
Aiding in the distinction between a reactive cytosis and a chronic myeloproliferative disorder
Evaluating mutations in CALR in an algorithmic process for the MPNR / Myeloproliferative Neoplasm, JAK2 V617F with Reflex to CALR and MPL, Varies
Reject Due To
| Gross hemolysis | Reject |
| Paraffin shavings | Reject |
| Slides | Reject |
| Moderately to severely clotted | Reject |
| Paraffin embedded bone marrow aspirate clot or biopsy blocks | Reject |
Method Description
Polymerase chain reaction (PCR) amplification of CALR exon 9 is performed on DNA isolated from the patient sample. The PCR product is then run on an ABI Genetic Analyzer for fragment analysis to detect insertions and deletions. An unmutated CALR will show an amplicon at 266 base pairs (bp), a mutated CALR with insertion will show an amplicon greater than 266 bp, and a mutated CALR with deletion will show an amplicon smaller than 266 bp. This assay has an analytical sensitivity of approximately 6% (ie, 6 mutation-containing cells in 100 total cells) in most mutation types, except for the rare type of 1-bp deletion, which has a sensitivity of approximately 20%.(Unpublished Mayo method)
Day(s) Performed
Monday through Friday