First slide
CytoCell fluorescence in situ hybridisation (FISH) logo.

Product summary

  • Chromosomes
    144
  • Labels    
  • Disease focus MM
  • Product code CE-LPH 074-S (5 tests) CE-LPH 074 (10 tests)
  • Regulatory status In vitro diagnostic.
Cytocell Catalogue Probe Packaging With Amber Tube
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Probe design

Overview

Probe specification

  • IGH, 14q32.33, Green

  • FGFR3, 4p16.3, Red

The IGH mix comprises three green-labelled probes: a 393 kb probe centromeric to the IGH constant region and two probes (324 kb and 289 kb) located within the IGH variable region. The FGFR3 mix comprises two red-labelled probes: a 118 kb probe telomeric to FGFR3 containing the D4S2561E marker, and a 126 kb probe centromeric to MMSET containing the D4S1182 marker.

Probe information

The FGFR3 (fibroblast growth factor receptor 3) gene is located at chromosome 4p16.3 and the IGH (immunoglobulin heavy locus) at chromosome 14q32.33. The t(4;14)(p16.3;q32.3) rearrangement is a recurrent IGH translocation and one of the primary clonal events identified in approximately 11-15% of newly diagnosed multiple myeloma (NDMM) patients.1,2

The t(4;14)(p16.3;q32.3) rearrangement involves the FGFR3, NSD2 (nuclear receptor-binding SET domain protein 2; previously known as WHSC1/MMSET) and IGH loci. This rearrangement is frequently cryptic by conventional chromosome analysis and is therefore commonly detected by fluorescence in situ hybridisation (FISH).1,3

 

Intended purpose

The CytoCell® IGH/FGFR3 Plus Translocation, Dual Fusion Probe is a qualitative, non-automated, fluorescence in situ hybridisation (FISH) test used to detect chromosomal rearrangements between the 4p16.3 region on chromosome 4 and the 14q32.33 region on chromosome 14 in Carnoy’s solution (3:1 methanol/acetic acid) fixed haematologically-derived cell suspensions from patients with confirmed or suspected multiple myeloma (MM).

 

Indications for use

This product is designed as an adjunct to other clinical and histopathological tests in recognised diagnostic and clinical care pathways, where knowledge of IGH::FGFR3 translocation status would be important for clinical management.

 

Limitations

This device is designed to detect rearrangements with breakpoints in the regions bounded by the red and green clones in this probe set, which include the IGH and FGFR3 genes.

Breakpoints outside these regions or variant rearrangements wholly contained within these regions, such as insertions, may not be detected with this product.

This device is not intended for: use as a stand-alone diagnostic, use as a companion diagnostic, prenatal testing, population-based screening, near-patient testing, or self-testing.

This device has not been validated for sample types, disease types, or purposes outside of those stated in the intended purpose.

It is intended as an adjunct to other diagnostic laboratory tests and therapeutic action should not be initiated on the basis of the FISH result alone.

Reporting and interpretation of FISH results should be performed by suitably qualified staff, consistent with professional standards of practice, and should take into consideration other relevant test results, clinical and diagnostic information.

This device is intended for laboratory professional use only.

Failure to adhere to the protocol may affect the performance and lead to false positive/negative results.

Product documentation

Recommended protocol for CytoCell haematology FISH

Select a protocol step to view:

Sample and slide preparation

Icon representing the sample and slide preparation stage of the fluorescence in situ hybridisation (FISH) protocol.
  • Spot the cell sample onto a glass microscope slide. Allow to dry.
  • Immerse the slide in 2x Saline Sodium Citrate (SSC) for 2 minutes at room temperature (RT) without agitation.
  • Dehydrate in an ethanol series (70%, 85% and 100%), each for 2 minutes at RT.
  • Allow to dry.

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References

  1. Alaggio R, Amador C, Anagnostopoulos I, et al. (eds.) (2022) WHO Classification of Haematolymphoid Tumours. 5th ed. Lyon: International Agency for Research on Cancer (IARC).
  2. Walker BA, Wardell CP, Brioli A, et al. Characterisation of IGH locus breakpoints in multiple myeloma indicates a subset of translocations appear to occur in pregerminal centre B cells. Blood. 2013;121(17):3413-3419.
  3. Stong N, Ortiz-Estévez M, Towfic F, Samur M, Agarwal A, Corre J, Flynt E, Munshi N, Avet-Loiseau H, Thakurta A. The location of the t(4;14) translocation breakpoint within the NSD2 gene identifies a subset of patients with high-risk newly diagnosed multiple myeloma. Blood. 2023;141(13):1574-1583
  4. Arsham, MS., Barch, MJ. and Lawce HJ. (eds.) (2017) The AGT Cytogenetics Laboratory Manual. New Jersey: John Wiley & Sons Inc.
  5. Mascarello JT, Hirsch B, Kearney HM, et al. Section E9 of the American College of Medical Genetics technical standards and guidelines: fluorescence in situ hybridization. Genet Med. 2011;13(7):667-675.
  6. Wiktor AE, Dyke DLV, Stupca PJ, Ketterling RP, Thorland EC, Shearer BM, Fink SR, Stockero KJ, Majorowicz JR, Dewald GW. Preclinical validation of fluorescence in situ hybridization assays for clinical practice. Genetics in Medicine. 2006;8(1):16–23.
  7. Wolff DJ, Bagg A, Cooley LD et al. Guidance for Fluorescence in Situ Hybridisation Testing in Hematologic Disorders. J Med Diagnost. 2007;9(2):134-143