• Test Code:
    4376
  • Department:
  • Test Synonyms:
    JAK2 V617FCalreticulinMPL
  • CPT Code(s):
    812708121981339
Background:

The majority of patients with BCR-ABL-negative myeloproliferative neoplasms (MPNs) include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF).  These patients carry an acquired mutation in either JAK2, CALR or MPL and these mutations are usually mutually exclusive.  Screening for these mutations not only helps to establish a diagnosis but also have an impact on the clinical outcome of these neoplasms.

Reasons for Referral:
The JAK2, CALR and MPL testing is done to molecularly subclassify myeloproliferative neoplasms, which is important in making the correct diagnosis as well as determining prognosis, and, in some cases, predicting responses to targeted and/or non-targeted therapy.

 

Methodology:

This test is performed by PCR-based Next Generation Sequencing of DNA extracted from peripheral blood or bone marrow.  The JAK2 V617F exon, hotspot exon 9 in CALR, and hotspot exon 10 in MPL are sequenced using massively parallel sequencing (next-generation sequencing) with a combination of multiplexed PCR (customized QIAseq Targeted DNA panel) and sequencing on an Illumina platform.  An in-house bioinformatics analysis pipeline has been used that employs multiple established variant calling tools (FreeBayes, MuTect2 and Scalpel) and variant annotation tools.  The genomic variants have been interpreted in accordance with the 2017 guideline recommendations by AMP/ASCO/CAP (PMID: 27993330).  The assay is validated in accordance with the AMP guidelines (PMID: 28341590).

Sensitivity:
The lower detection limit for JAK2 V617F is 1% VAF; CALR and MPL are 1-2% VAF; depending on read quality and quantity.

Specimen Requirements:

  • Blood:5-7mL EDTA or ACD (Solution A or B)
  • Bone Marrow: 2-3mL EDTA or ACD (Solution A or B)
  • DNA: 200ng at a minimum of 25ng/µL (DNA must be extracted in a CLIA-certified laboratory or a laboratory meeting equivalent requirements as determined by the CAP and/or CMS)

  • A REQUISITION FORM MUST ACCOMPANY ALL SAMPLES.  Please include detailed clinical information.

    Test Performed (Days):

    Weekly

    Turn Around Time:

    7-14 days

    Shipment Sensitivity Requirements:

  • Package and ship specimen to remain cold, but not frozen. 
  • Ship via overnight express, using the FedEx priority overnight label provided. 
  • Contact Client Services for shipping kits and instructions at (855) 535-1522.
  • References:

    Additional Info:

    The Knight Cancer Institute at Oregon Health & Science University is a pioneer in the field of precision cancer medicine. The institute's director, Brian Druker, M.D., helped prove it was possible to shut down just the cells that enable cancer to grow. This breakthrough has made once-fatal forms of the disease manageable and transformed how cancer is treated. The OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle – an honor earned only by the nation's top cancer centers. It is headquarters for one of the National Cancer Institute's largest research collaboratives, SWOG, in addition to offering the latest treatments and technologies as well as hundreds of research studies and clinical trials.

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