Chimerism Assessment by Polymorphic Microsatellite Markers (Post-Transplant), PCR
Pre-transplant Screening
Indication
- To evaluate and monitor engraftment after hematopoietic stem cell transplant using total cells (both peripheral blood and bone marrow) and ,sorted T- and myeloid cells (bone marrow only). Detection of microsatellite markers that are exclusively donor in origin indicates successful engraftment. Serial values showing a decline i engraftment of donor cells may predict a graft-failure in appropriate clinical settings.
- To identify the source of successful engraftment when more than one donors are used from the hematopoietic stem cell transplant.
Methodology
Chimerism testing for assessment of stem cell engraftment is performed on genomic DNA extracted from peripheral blood or bone marrow aspirate samples. For peripheral blood samples, additional testing is performed on DNA from sorted T-lymphocytes, myeloid cells and/or NK cells as applicable.
Eight highly informative microsatellite markers are amplified in three multiplex-PCR reactions using (Forward or Reverse) primers labeled with fluorescent tags.
PCR products are loaded on an ABI 3730xl Genetic Analyzer for size fractionation, and quantification. The collected raw data are analyzed for the size and quantity of the peak area of the fragments using GeneMapper® Software.
For the initial testing on any patient, the test is performed on 3 separate DNA samples: donor DNA, recipient Pre-transplant (germline) DNA, and recipient post-transplant DNA sample to identify an informative marker that can distinguish between the donor and recipient. This unique marker will be used for subsequent Chimerism analysis by importing pre & donor profiles from archives for analysis.
Final results are reported as percentage of donor DNA in total (Donor + recipient) DNA in the sample.
Test Parameters
Peripheral blood samples are required from both donor and recipient.
Turnaround Time
Five to seven working days
Sample Requirements
- Three 10 ml peripheral blood in purple top tube (EDTA Vacutainer), sent on wet ice
or
- 2-5 ml of bone marrow aspirate, sent on wet ice
CPT Codes
81265, 81267, 81268
The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.