B-ALL MRD, Bone Marrow

B Lymphoblastic Leukemia MRD, B cell acute leukemia MRD, Minimal residual disease, MRD by flow cytometry, COG Day 29, B-ALL MRD

Test Codes

EPIC: LAB1230328, Beaker: B ALL MRD BM

Department

Send Outs

Specimen Collection Criteria

Collect: Bone Marrow Aspirate.

Container/Tube: 4.0 mL Sodium Heparin (NaHep Green) or 3.0 mL Lavender-top EDTA. (Minimum: 3.0 mL/ 2.0 mL neonate)

Physician Office/Draw Specimen Preparation

Do not centrifuge. Maintain bone marrow in original collection tubes, at room temperature (20-26°C or 68-78.8°F).

Preparation for Courier Transport

Transport: Bone marrow, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

• Clotted specimens.
• Frozen specimens.
• Specimens not collected and processed as indicated.

In-Lab Processing

Do not centrifuge. Maintain bone marrow in original collection tubes, at room temperature (20-26°C or 68-78.8°F).

Transport: Bone marrow, at room temperature (20-26°C or 68-78.8°F).

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal: 7 days

Laboratory

Sent to Corewell Health Advanced Technology Laboratory (ATL), Grand Rapids, MI.

Performed

Monday – Sunday.
Results available in 1-3 days.

Reference Range

An interpretative report will be provided.

Test Methodology

Flow Cytometry Immunophenotyping

Interpretation

Minimal residual disease (MRD) is a powerful prognostic factor for predicting outcomes in pediatric B cell acute lymphoblastic leukemia (B-ALL). This flow cytometry assay is an effective method for measuring MRD and is the COG approved MRD test for patients enrolled on AALL0932 and AALL1131 day 8 of COG protocol; other time points in therapy are also accepted. This flow cytometry assay involves the staining of white blood cells in a bone marrow sample with a viability of dye and monoclonal antibody to CD3, CD9, CD10, CD13, CD19, CD20, CD33, CD34, CD38, CD45, CD58, and CD71. Additional markers may be evaluated if phenotypic characteristics indicate the need. This flow cytometric assay has the ability to enumerate and characterize very small populations of abnormal cells, often as low as 1 in 10,000 cells.

Clinical Utility

This test is appropriate for patients previously diagnosed with B-ALL and may be run at any time point in therapy.

This is a COG approved MRD test for patients enrolled on AALL0932 and AALL1131. Day 29 of COG protocol. May be ordered post consolidation; other timepoints in therapy are also accepted.

CPT Codes

88184
88185 x 12
88188

Contacts

Last Updated

10/24/2025