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Test Code 5856 Immunoglobulin Heavy-Chain (IGH) Gene Rearrangement

Performing Laboratory

Barnes-Jewish Hospital Laboratory


Extracted genomic DNA is analyzed by a laboratory-developed test using the LymphoTrack® Dx IGH Assay reagents from InVivoScribe Technologies. Massively parallel (“Next-generation”) sequencing of libraries is performed on a Life Technologies Ion Torrent S5™ sequencer. IGH rearrangement sequences are detected and relative proportion determined as a percentage of total sequencing reads using the LymphoTrack® Dx IGH clonality testing software. Limitations: The assay primers cannot detect 100% of possible IGHV rearrangements. Low DNA input, DNA degradation, and/or interfering substances may cause failure to detect an IGH rearrangement by this assay.


Literature References

1. Tonegawa S. Somatic generation of antibody diversity. Nature. 1983;302(5909):575-581.

2. Gazzola A, Mannu C, Rossi M, et al. The evolution of clonality testing in the diagnosis and monitoring of hematological malignancies. Therapeutic advances in hematology. 2014;5(2):35-47.

Specimen Requirements

Call Barnes-Jewish Hospital Molecular Diagnostics Laboratory at 314-454-8685 for collection instructions.


Forms: Molecular Diagnostics Laboratory Request for DNA Studies-Oncology in Special Instructions.


Submit only 1 of the following specimens:


Specimen Type: Blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: Full tube

Specimen Minimum Volume: 1 to 2 mL

Collection Instructions:

1. Invert several times to mix blood.Clotted blood is not acceptable.

2. Specimen cannot be frozen.


Specimen Type: Bone marrow

Container/Tube: Lavender top (EDTA)

Specimen Volume: 1 to 2 mL

Collection Instructions:

1. Invert several times to mix bone marrow. Clotted bone marrow is not acceptable.

2. Specimen cannot be frozen.


Specimen Type: Tissue, formalin-fixed, paraffin-embedded

Container/Tube: Sterile, microcentrifuge tube

Specimen Volume: Twenty, 10-micron sections


Specimen Type: Tissue, fresh

Container/Tube: Sterile, plastic container

Specimen Volume: 10 mm3

Additional Information: Forward frozen tissue on dry ice.

Day(s) Test Set Up

Turnaround Time:
STAT: not available
Routine: 7 to 10 business days

Reference Values

An interpretative report will be provided.

Test Classification and CPT Coding


Additional Information

For BJH Laboratory Use Only

Analyte Stability:

Blood and bone marrow are stable 0 to 4 hours at ambient temperature, up to 96 hours refrigerated.
FFPE tissue stable indefinitely.
Fresh-frozen tissue is stable at -20° C.

Laboratory Processing Instructions:
Test performed in BJH Molecular Diagnostics.

Specimen Transport Temperature

Ambient/Refrigerate NO/Frozen NO-Blood; Bone Marrow; Tissue, Formalin-Fixed, Paraffin-Embedded

Frozen on Dry Ice-Tissue, Fresh