FLT3-ITD/FLT3 D835, F691/NPM1

Purpose: Mutations in FLT3 and NPM1 are commonly seen in acute myeloid leukemia. The presence of FLT3 mutations may predict sensitivity or resistance to targeted therapies, and the presence of FLT3/NPM1 mutations are associated with prognosis.
Commonly seen FLT3 internal tandem duplications (FLT3-ITD) in the juxtamembrane domain and NPM1 mutations in exon 12 (most commonly a 4 base pair insertion/duplication) are detected by PCR and capillary electrophoresis. Missense F691 and D835 mutations in exon 17 and exon 20 of FLT3 are detected by PCR and direct dideoxyterminator DNA sequencing.
CPT Codes: 81245, 81246, 81310
Methodology: PCR and capillary electrophoresis and PCR-Sanger sequencing of DNA obtained from blood, bone marrow, or cell suspensions. At least 30% or greater lesional cells are required for detection.  This test should not be ordered for MRD evaluation.
Turnaround Time:  5 days
Sample Tested: Blood, bone marrow, cell suspensions and/or extracted DNA.
Forms: 1. PGM Oncology Requisition
2. Medicare Advance Beneficiary Notice